fractured tibia non union for 2 years

My father is suffering from tibial infection and non union for 2 years. First doctors placed a plate with screw which resulted in infection in bone... then to cure infection antibiotics were administered and ilizarov frame was fixed in the tibia. Now frame has also removed but bone is still not joined. The doctors have also done bone grafting to fill the gap but it didn't work even.

Can any one suggest what could be done..????

[Dr Vinod]

Hello!

The infection is the main reason for non union. You should treat the infection completely and should make sure there is no infection.
As you have tried nailing with bone grafting and also Ilizarov's method now you have to discuss with the surgeon to repeat this with electromagnetic stimulation or go for Phemister grafting.
Phemister grafting is a type of bone grafting where the grafting is performed without disturbing the sound fibrous union at the fracture site. Cancellous bone grafts are placed after raising the osteo-periosteal flaps around the fracture and petalling i.e. lifting slivers of cortical bone attached at base is carried out.
This has to be done by an expert.

Take care!

[mayuresh]

Thanks for ur advice doctor !! Can u tell me more about this Phemister Grafting...
where can it be done in India.

Can you suggest me if a micro-vascular surgery could help in union and curing infection .  ????

Also one big problem is that here no doctor is able to suggest a proper way to cure the bone infection. ?? they always say that it cant be cured completely..

Last year in May when my father was suffering from severe bone infection...the doctors suggested for ilizarov frame. The fracture was in upper part of tibia near the knee with 1.5 inch gap due to infection. They broke the tibia from bottom and by screwing the frame for 2 months the bone shifted upside reducing the gap. The gap was created in the bottom part of tibia which in now joined. But still,
the upper part of tibia is not united even the gap is reduced. the x-ray shows a very small instance of callus formation which i am not sure it is callus.
Plz suggest me something which works.....its now two years!!!!!!! Please..

[Dr Vinod]

Hello!

As I told you his primary problem is infection and I would suggest you to go to a good facility anywhere in India with the best asepsis measures.
More than the procedure of surgery the infection should be cleared and you need to check this out with the orthopedician before undergoing any method.

You can go to central institutions like AIIMS, Gangaram or private institutions like Fortis etc whichever is suitable.

Take care!

[mayuresh]

is the Sancheti Hospital in Pune is better place for orthopaedics... i heard a lot about it... plz suggest A good Dr. .

A very thanks for you guidance..