Introduction. Nonunion of long bones may often be associated with significant
function loss of affected extremity, joint stiffness, and even extremity
amputation or systemic manifestations in the case of infection. The aim of
this case report is to highlight the possibilities of Ilizarov apparatus in
the treatment of fracture nonunions of both lower legs treated by different
operative methods and to show that it is not necessary to remove
osteosynthetic material (intramedullary nail) in every case when nonunion
occurs to achieve its recovery. Case Report. A 62 year-old man was injured in
a traffic accident as a pedestrian in April 2012, when he experienced
polytrauma, including shaft fracture of the right femur, and segmental open
fractures of the right (Gustillo-Anderson grade I) and left
(Gustillo-Anderson grade II) lower leg. The fractures of right femur and
right tibia were stabilized initially with intramedullary nails, while the
left lower leg fracture was treated by unilateral external fixator. After 5
months, there were no clinical and radiographic signs of union on lower legs,
therefore the patient underwent re-surgery. Ilizarov apparatus was applied on
both lower legs. The patient was early verticalized and both apparatus were
removed after 4 months. According to the modified protocol of the Association
for the Study and Application of Methods of Ilizarov, the lower leg bony
results were good and excellent, and the functional results were excellent on
both sides. Conclusion. Nonunion fracture of the right lower leg initially
treated by the method of intramedullary osteosynthesis and afterwards by
placing Ilizarov apparatus shows that in some cases it is not indicated to
remove fixative material in order to achieve full recovery of fracture, thus
eliminating the danger of all negative effects resulting from the classical
extensive surgical treatment.
Total Spinal Anesthesia as a Complication of Epidural Nerve Block: A case report
