Ilizarov treatment for pseudarthrosis of the tibia due to haematogenous osteomyelitis.

Haematogenous osteomyelitis is associated with poverty and overcrowding. The infection may extend through the entire length of a long bone and as a part of debridement, the sequestrum may be removed, resulting in a defect. Infection of tibial growth plates would result in altered growth rates of the tibia and fibula and produce deformities and shortening. Fourteen children were treated for pseudarthrosis of the tibia because of haematogenous osteomyelitis. Their ages ranged from 4 to 13 years. There were nine male and five female children. The treatment included the use of Ilizarov techniques in the form of distraction of a stiff pseudarthrosis (n=5) and acute shortening and relengthening for bone defects (n=9). No active infection was present at the time of treatment. In all cases, the bone defects were bridged and consolidated. No residual infection was present. Transient palsy of the common peroneal nerve occurred in two cases during deformity correction and lengthening. Refracture occurred in one case at the site of a previous wire. Residual leg shortening of more than 1 inch was present in two cases. The results were satisfactory in 12 cases (86%) and unsatisfactory in two cases (14%) because of residual shortening and ankle joint fusion. Ilizarov techniques comprehensively address the problems associated with chronic haematogenous osteomyelitis of the tibia in children despite the difficulties in their application because of the nature of the illness.