Predictors of Bone and Functional Outcomes Of Ilizarov Ring Fixation in the Treatment of Infected Non-Union of the Distal Femur
DOI:
https://doi.org/10.64149/J.Ver.8.18s.51-59Keywords:
Study Design and Patient Selection, Preoperative Assessment and Surgical Technique.Abstract
Background: Infected non-union of the distal femur is a major clinical challenge. While the Ilizarov technique is used, success predictors are poorly defined. This study aimed to identify predictors of bone and functional outcomes after Ilizarov fixation for this condition.
Methods: A prospective cohort study followed 20 patients (mean age 34.1) treated for infected distal femur non-union from 2023-2024. All underwent radical debridement and Ilizarov stabilization. Outcomes were evaluated using ASAMI criteria.
Results: Successful bone and functional outcomes were achieved in 85% and 70% of patients, respectively. Pin site infection occurred in 65%. Significant predictors for poorer bone outcomes included: >3 previous operations (p=0.035), treatment >45 weeks (p=0.022), hospital stay >15 days (p=0.030), pin site infection (p=0.027), axial deviation >7° (p=0.022), and delayed weight-bearing (>10 days, p=0.011). Significant predictors for poorer functional outcomes included: the presence of comorbidities (p=0.003), >3 previous operations (p=0.036), treatment >45 weeks (p=0.007), hospital stay >15 days (p=0.008), pin site infection (p=0.004), axial deviation >7° (p=0.007), and delayed weight-bearing (>10 days, p=0.011).
Conclusions: Success is achievable but significantly associated with surgical history and postoperative care. A history of multiple failed surgeries, prolonged treatment, and complications like pin site infection are strong negative predictors. Findings support early Ilizarov treatment and meticulous postoperative management.
Level of Evidence: Therapeutic Level IV.
