Study of Limb Reconstruction System in the Management of Nonunion in Fractures of Long Bones

Introduction: The prevalence of open fractures in long bones is on the rise, primarily attributed to the increased frequency of road traffic accidents, resulting in a higher occurrence of nonunion in long bones. While various devices are employed in nonunion treatment, the limb reconstruction system (LRS) stands out as a straightforward and effective solution with a commendable union success rate; it possesses the capability to either distract or compress fractures, enabling the crucial dynamization process essential for nonunion treatment. Objective: Evaluate union rates with LRS long bone nonunion fractures, study the complications and duration of treatment with LRS in long bone fracture nonunions, and study the necessity for secondary procedures, such as bone grafting, bone marrow injections, or soft tissue coverage, to enhance healing during LRS treatment. Materials and Methods: This is a retrospective and prospective study comprising 33 cases of long bone (humerus, femur, and tibia) fracture nonunion treated using the LRS through compression and distraction osteogenesis. The association for the study and application of method of Ilizarov scoring system was used for the assessment of results. Results: The treatment modalities employed were compression with bone transport in 17 cases, compression–distraction in 03 cases, and compression in 13 cases. Fracture sites were compressed at a rate of 0.25 mm/day for 1–2 weeks, distraction rate of 1 mm/day was applied at corticotomy sites (ideally in four sessions per day) until the desired lengthening was achieved. At the end of our study and 1 year of minimum follow-up, we obtained: bone result: 80% excellent, 10% good, and 10% poor and functional result: 40% excellent, 50% good, and failure in 10% of cases. Conclusion: In the treatment of long bone nonunion, especially in cases of infected nonunion and nonunions with significant shortening, LRS excels. Constructing the frame is easy; it is more practical for the patient and surgeon.