Introduction:
Subtrochanteric nonunion represents a formidable challenge facing the orthopedic surgeon. The purpose of this study was to evaluate the radiographic and the functional outcome of using the Ilizarov technique for treatment of nonunited subtrochanteric fractures.
Patients and Methods:
This retrospective study included 14 patients with subtrochanteric nonunions treated by Ilizarov fixator. The study included 12 males and two females with a mean age of 41 years. Eleven nonunions were in the right side and the others were left nonunions. Eight cases were infected nonunions and six cases were aseptic. The nonunion duration averaged 23.36 months. All patients had previous surgeries with a mean of 3.14 procedures. The mean shortening was 3.96 cm, and seven cases had varus deformity.
Results:
Thirteen patients were treated by bifocal management. Lengthening was postponed in one patient with residual shortening of 4 cm. The mean follow-up duration was 32.79 months. The external fixator period ranged from 8 to 14 (Mean 11.64) months. Union was achieved in all cases with restored alignment. Infection recurred in one patient after quiescence and frame removal. One case suffered a fracture through the lengthening part after fixator removal. The ASAMI bone grade was excellent in 11 cases, good in two cases, and poor in the remaining one. The ASAMI functional grade was excellent in ten patients and good in four.
Conclusion:
Up to the authors' best knowledge, this is the first reported series selective to subtrochanteric nonunions managed by Ilizarov fixator. Despite complications, Ilizarov external fixator provided a viable multipurpose solution for these complicated disabling nonunions.