The Application of Llizarov Fixator Combined with Antibiotic-laden Bone Cement in Treatment of Infectious Bone Defect of Long Bone

Abstract：Objective To discuss the individual-based treatment technique and clinical effects of long bone with infectious bone defects using Ilizarov fixator combined with antibiotic-laden bone cement.Methods From June 2011 to January 2017, 21 patients suffered femoral, tibial and humeral infected nonunion with bone defects underwent operation in our hospital.The cases included 14 males and 7females aged 37 (18～65years).The site of infected nonunion involved12 tibias, 7femurs and 2humerus.After debridement, the mean bone defect length of tibia was 7.2cm, the mean bone defect length of femur was 8.5cm, the mean bone defect length of humerus was 6.0cm.Surgery was performed in two stage.The antibiotic-laden bone cement was implanted to control infection and form a bone-induced membrane after the infected scarred soft tissue and necrotic bone were debrided radically in the primary stage, the affected limb was fixed for bone transport by monolateral external fixator or fixed for bone transport by Ilizarov external fixator.After infection controlled, the bone transport was performed by Ilizarov technology in second stage.Results All the patients were followed up for 12 to 24months with an average of 18.5months, the average fixation time was 17.2months (range from9 to 21months), the mean external fixation index was 2.38months/cm.Bone results and functional results were evaluated by ASAMI classification.The bone results were excellent in 13 patients, good in 6patients and fair in 2patients.Good and excellent rate in bone results was 90.5％.The functional results were excellent in 11 patients, good in 7patients and fair in 3patients, good and excellent rate in functional results was 85.7％in our study.Conclusion Our study suggested that Ilizarov fixator combined with antibiotic-laden bone cement can control infection effectively, correct deformity and rebuild limb function, was an effective method of treating long bone with infectious bone defects.