Limb Reconstruction System for Infected Nonunion: A Retrospective Study

Introduction: Infected non-union of long bones is a complex orthopedic challenge, leading to prolonged disability and healthcare burden. The limb reconstruction system (LRS) offers advantages over the Ilizarov technique, including early weight-bearing, minimal invasiveness, and improved functional outcomes. This study evaluates the clinical and functional outcomes of infected nonunion treated with LRS. Materials and Methods: A retrospective study was conducted at a tertiary care center in eastern India from January 2019 to June 2023, including a pandemic-affected period. Thirty patients (18–68 years) with infected nonunion of the femur, tibia, and humerus were included. Data on demographics, infection characteristics, prior surgeries, and hematological parameters were recorded. All patients underwent surgical debridement followed by LRS application. Outcomes were assessed using the Association for the Study and Application of the Method of Ilizarov scoring system. Results: Of 30 patients, 16 had femoral nonunion, 11 tibial, and 3 humeral. Union was achieved in 83.33% (25 cases), and infection eradication in 93.33% (28 cases). The mean time to union was 9.1 months. Complications included joint stiffness (26.67%), pin tract infection (23.33%), and limb length discrepancy (40%). No amputations were required, and re-fracture rates were low. Conclusion: LRS is a reliable and effective treatment for infected nonunion, enabling early mobilization and good functional outcomes. It provides a stable alternative to Ilizarov fixation with low complication rates. Keywords: Infected nonunion, limb reconstruction system, external fixation, bone union, orthopedic infection, Ilizarov technique.