Study of Factors Affecting the Clinical and Radiological Outcome in Management of Infected Non-Union of Tibia Managed with Ilizarov Ring Fixator and its Correlation with Patient-Reported Outcome: Prospective Descriptive Study.

Abstract

Background: Non-union of fracture of tibia is often associated with multiple problems like infection, deformity, bone loss, and soft tissue loss. Ilizarov is a worldwide accepted treatment for infected non-union of tibia, but correlation of patient-rated outcome measures with surgeon-assessed clinical and radiological outcomes is not being done in the literature.

Objectives: To analyze the variables affecting clinical and radiological outcomes and patient-reported outcomes (EQ5D5L) and to assess correlation between patient-reported outcome measures and ASAMI scores during management of infected nonunion of tibia with Ilizarov ring fixator.

Patients and methods: Thirty three patients aged between 18 and 70 years, both sexes, presenting with infected non-union tibia.

Results: The mean age was 39.51 ± 14.94 years ± SD, pre-operative EQ5D5L score was > 20 in 87.9%, patients mean value is 21.061 ± 3.508 SD, mean non-union severity score was 51.7 ± 15.7 SD, mean Infection Severity Score is 44.485 ± 18.755 SD. The correlation of the variables affecting the ASAMI radiological score: Distal 1/3rd and midshaft, Smoking, Alcohol, Non-union severity score, Infection severity score had negative correlation, with significant p value and EQ5D5L score immediate post-operative score and EQ5D5L follow up had positive correlation with ASAMI radiological score. Gap / bone loss score had negative correlation, p value being 0.058+. EQ5D5L immediate post-operative score and EQ5D5L follow up had positive correlation with significant p value with ASAMI clinical score.

Conclusion: Ilizarov fixator is an excellent tool in managing infected nonunion of tibia with bone loss with good patient rated outcome and ASAMI clinical and radiological score.