Ilizarov external fixator effective in management of post-traumatic infected non-union of the humerus: study

Written by Dr Supreeth D R Published On 2025-08-27T20:15:06+05:30 | Updated On 27 Aug 2025 8:15 PM IST

Ilizarov external fixator effective in management of post-traumatic infected non-union of the humerus: study

Rajesh Rohilla et al conducted a study to evaluate the functional and clinico-radiological outcomes of management of septic non-union of the humeral fractures managed with hybrid ring fixator. The study has been published in ‘Indian journal of orthopedics.’

A total of 18 patients with post-traumatic infected non-union of humerus were included. The mean age was 30.8 years and mean duration of presentation after injury was 19.1 weeks. Mean follow-up duration was 28.11 months and mean time of fixator removal was 25.28 weeks. Bone and functional results were evaluated using the modified Association for the Study and Application of the Method of Ilizarov (ASAMI) criteria, and disability of arm, shoulder and hand (DASH) scores.

The key findings of the study were:

• Thirteen out of 18 patients had positive culture of Staphylococcus aureus and 5 patients had either contamination (mix growth) or quiescent (not detected) growth in infected tissues.

• Average duration of final follow-up was 28.11 months (12–51 months).

• Mean duration of fixation was 25.28 weeks (22–30 weeks).

• Bone union was achieved primarily in 16 (88.8%) patients.

• According to modified ASAMI criteria, the bone results were excellent, good, fair, and poor in 9 (50%), 7 (38.9%), 0 and 2 (11.1%) patients, respectively, whilst functional results were excellent, good, fair, and poor in 11 (61.1%), 5 (27.8%), 0 and 2 (11.1%) patients, respectively.

• The mean DASH score was 15.27 (5.8–50) at the final follow-up.

• The mean limb length shortening was 2.67 cm (2–5 cm), whereas malunion of more than 15 deg angulation was observed in three patients.

The authors concluded – “Hybrid ring fixator is very effective in management of post-traumatic infected non-union of the humerus. Good-to-excellent bone and functional results can be achieved in majority of patients. Elbow stiffness and superficial pin tract infections are common problems encountered by patients.”

Level of Evidence IV, A Retrospective study.

MBBS, Dip. Ortho, DNB ortho, MNAMS

Dr Supreeth D R (MBBS, Dip. Ortho, DNB ortho, MNAMS) is a practicing orthopedician with interest in medical research and publishing articles. He completed MBBS from mysore medical college, dip ortho from Trivandrum medical college and sec. DNB from Manipal Hospital, Bengaluru. He has expirence of 7years in the field of orthopedics. He has presented scientific papers & posters in various state, national and international conferences. His interest in writing articles lead the way to join medical dialogues. He can be contacted at editorial@medicaldialogues.in.