One-stage management of post-traumatic tibial infected nonunion using bone transport after debridement

To evaluate the results of the management of post-traumatic tibial infected nonunion using bone transport with external fixators. Materials and methods: We retrospectively reviewed a consecutive series of 35 patients from 2000 to 2008 in our hospital who were treated for the post-traumatic tibial nonunion by bone transport with an external fixator. Thirty-two limbs (80%) were in active infected state. The mean amount of bone defect was 3.5 cm (range 1.0 to 7.8 cm) as measured on plain radiographs. The mean leg-length discrepancy was 4.4 cm (range 0 to 8.7 cm). Results: The mean follow-up was 72.5 months (range 35-106 months). All the patients had bony union and the infection had been controlled. The mean external fixation index was 40.7 day/cm (range 34.2-46.9 day/cm). The mean length gained was 7.9 cm (range 4.0-10.5 cm). Based on the criteria recommended by Paley et al., 28 bone results were excellent, 5 good, 2 fair, and none poor; 30 functional results were excellent, 4 good, 1 fair, and none poor. Conclusion: Bone transport with an external fixator is a safe, effective, and minimally invasive technique to treat post-traumatic tibial infected nonunion.