RT Journal Article
SR Electronic
T1 Management of femoral shaft infected nonunion through customised Ilizarov external fixator assembly in a morbidly obese patient
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e245824
DO 10.1136/bcr-2021-245824
VO 15
IS 1
A1 Muhammad Saad Ilyas
A1 Abdul Sattar
A1 Uruj Zehra
A1 Amer Aziz
YR 2022
UL http://casereports.bmj.com/content/15/1/e245824.abstract
AB A 19-year-old morbidly obese man presented with infected nonunion of femoral shaft fracture. Patient had history of 13 failed fixation surgeries, assessment revealed 3-centimetre limb-length discrepancy with 3-centimetre gap nonunion. Wound debridement, primary compression and external fixation using a customised Ilizarov external fixation assembly were planned. A four-ring customised assembly was applied. Partial weight bearing was allowed from first postoperative day on walker. Patient was kept on a monthly follow-up. After complete union at 10 months after surgery, frame was dynamised. After 6 months of dynamisation, frame was removed, at that time patient was full weight bearing. Knee was still stiff with a range of motion of 0°–20°, and there was 6 cm of limb length discrepancy, which was managed with a shoe raise. At 9 months after frame removal, patient is mobile with fully united bone. Ilizarov external fixator can be a good managing option in such difficult and complicated cases.