Journal of Musculoskeletal Trauma

Treatment Strategy of Infected Nonunion: Hyoung Keun Oh; J Korean Fract Soc 2017;30(1):52-62. Published online January 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.1.52

The management of infected nonunion is based on a detailed evaluation of patients, the involved bone and soft tissues, stability of fixation, and type of bacterial pathogens. Preoperative surgical planning and strategies for each step is mandatory for the successful treatment of infected nonunion. The radical debridement of infected tissues, including the unstable implant, is one of the most important procedures. Adequate soft tissue coverage should be considered for the appropriate management of infection; a reconstructive procedure and stable skeletal stabilization by internal or external fixation is also necessary later. A restoration of bone defects and bony union can be accomplished with bone grafting, distraction osteogenesis, vascularized fibular grafting, and induced membrane technique.

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Systematic Diagnosis and Treatment Principles for Acute Fracture-Related Infections
Jeong-Seok Choi, Jun-Hyeok Kwon, Seong-Hyun Kang, Yun-Ki Ryu, Won-Seok Choi, Jong-Keon Oh, Jae-Woo Cho
Journal of the Korean Fracture Society.2023; 36(4): 148. CrossRef
The Antibiotic Cement Coated Nail and Masquelet Technique for the Treatment of Infected Nonunion of Tibia with Bone Defect and Varus Deformity: A Case Report
Min Gu Jang, Jae Hwang Song, Dae Yeung Kim, Woo Jin Shin
Journal of the Korean Fracture Society.2022; 35(1): 26. CrossRef

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The Treatment of Infected Non-union of Long Bones with Plate and Screws: Han Suk Ko, Yeong Hun Kang, Deok Weon Kim, Jeong Ku Ha; J Korean Fract Soc 2006;19(1):72-77. Published online January 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.1.72

Abstract

PURPOSE
To evaluate the usefulness of internal fixation with plate in treating infected nonunion of long bone.
MATERIALS AND METHODS
From March 1993 to February 2004, ten patients who underwent internal fixation with plate and cancellous bone graft on account of infected nonunion of long bone were retrospectively examined. The medical treatment were composed of thorough and adequate debridement of necrotic tissue, irrigation and plate fixation. Two patients were operated on with bridging plate method. Autologous cancellous bone graft was performed in 6 patients. In 2 cases, it was performed 4 weeks after internal fixation.
RESULTS
In 9 patients, radiographic union appeared on the average of 6.8months and infections were cured before union occurred.
CONCLUSION
Internal fixation with plate is a useful method for the solid fixation in the treatment of infected nonunion. The general concern was that the inserted hardware worsened the infection, which was overcomed with the operative techniques as bridging plate, debridement and cancellous bone graft.

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Treatment Strategy of Infected Nonunion
Hyoung-Keun Oh
Journal of the Korean Fracture Society.2017; 30(1): 52. CrossRef

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Vascularized Fibular Graft in the Treatment of Chronic Osteomyelitis of Long Tubular Bone: Kwang Suk Lee, Sang Won Park, Kyung Jo Woo, Jong Won Kim; J Korean Soc Fract 1997;10(2):365-370. Published online April 30, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.2.365

Abstract PDF: Previous management of chronic osteomyelitis has included antibiotic therapy, radical debridement, skin-grafting, distant cross-leg flaps, and local muscle flaps. Each of these modalities of treatment has limitations. However, over the last 20 years, vascularized fibular bone grafts have proved to be a valuable method of reconstruction of skeletal defects in the extremities following both infected and uninfected skeletal nonunions unresponsive to conventional methodology. We evaluated the efficacy of vascularized fibular graft in the treatment of chronic osteomyelitis of long bone. From August 1988 to June 1995, fourteen cases of chronic osteomyelitis of long bone which were followed for an average of 3 years duration were treated by vascularized fibular graft at the Department of Orthopaedic Surgery, Korea University Hospital. The results were as follows; 1. Even if the long tubular bone infection was uncontrolled, vascularized fibular graft could be performed and it was highly resistent to local infection. 2. Twelve cases (85.7%) out of a fourteen cases had primarily obtained bony union. 3. Free vascularized fibular graft is significant and reliable porcedure of bone grafting for the treatment of chronic osteomyelitis of long tubular bones.

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