ONE-STAGE VERSUS TWO-STAGE PROTOCOL IN MANAGEMENT OF INFECTED NONUNITED FRACTURE FEMUR; RANDOMIZED CONTROLLED TRIAL
Emara, K., Diab, R., El-Kersh, M., Mounir, A., Badreldin, A. (2021). ONE-STAGE VERSUS TWO-STAGE PROTOCOL IN MANAGEMENT OF INFECTED NONUNITED FRACTURE FEMUR; RANDOMIZED CONTROLLED TRIAL. EKB Journal Management System, 72(3), 505-515. doi: 10.21608/asmj.2021.205371
Khaled M Emara; Ramy A Diab; Mohamed A El-Kersh; Ayman F Mounir; Ahmed M Badreldin. "ONE-STAGE VERSUS TWO-STAGE PROTOCOL IN MANAGEMENT OF INFECTED NONUNITED FRACTURE FEMUR; RANDOMIZED CONTROLLED TRIAL". EKB Journal Management System, 72, 3, 2021, 505-515. doi: 10.21608/asmj.2021.205371
Emara, K., Diab, R., El-Kersh, M., Mounir, A., Badreldin, A. (2021). 'ONE-STAGE VERSUS TWO-STAGE PROTOCOL IN MANAGEMENT OF INFECTED NONUNITED FRACTURE FEMUR; RANDOMIZED CONTROLLED TRIAL', EKB Journal Management System, 72(3), pp. 505-515. doi: 10.21608/asmj.2021.205371
Emara, K., Diab, R., El-Kersh, M., Mounir, A., Badreldin, A. ONE-STAGE VERSUS TWO-STAGE PROTOCOL IN MANAGEMENT OF INFECTED NONUNITED FRACTURE FEMUR; RANDOMIZED CONTROLLED TRIAL. EKB Journal Management System, 2021; 72(3): 505-515. doi: 10.21608/asmj.2021.205371

ONE-STAGE VERSUS TWO-STAGE PROTOCOL IN MANAGEMENT OF INFECTED NONUNITED FRACTURE FEMUR; RANDOMIZED CONTROLLED TRIAL

Ain Shams Medical Journal
Article 9, Volume 72, Issue 3, September 2021, Page 505-515  XML PDF (720.18 K)
Document Type: Original Article
DOI: 10.21608/asmj.2021.205371
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Authors
Khaled M Emara1; Ramy A Diab1; Mohamed A El-Kersh1; Ayman F Mounir1; Ahmed M Badreldin2
1Orthopaedic Surgery Department, Faculty of Medicine – Ain Shams University, Egypt.
2Orthopaedic Surgery department Embaba General Hospital, Ministry of Health, Cairo, Egypt.
Abstract
Background: The rate of complex fracture non-unions is increased. Infected non-united fractures need more search for the best method of management.
Aim of the work: to compare one-stage protocol (external fixation) and two-stage protocol (debridement, removal of metal, and internal fixation after eradication of infection) in cases of infected non-united fracture femur.
Patients and methods: The study was conducted at the Orthopaedic Surgery department Ain Shams University Hospital and Embaba General Hospital from Sep-2017 to Sep-2020 on 20 patients grouped into: one-stage protocol 10 cases and two-stage protocol 10 cases.
Results: There was no significant difference between groups concerning age and gender. The healing time was 8.6±2.5 and 8.4±1.7 months for the one-stage group & the two-stage group, respectively. The range of motion of knee six months after healing was significantly (p-value = 0.025) better in the two-stage group. The median (IQR) range of movement was 100 (50) and 110 (30) degrees for the one-stage group & the two-stage group, respectively. The most frequent complication in the one-stage group was PTI (100% of cases); however, in the two-stage group, it was the recurrence of infection (30%), (p-value = 0.01).
Conclusion: The two-stage strategy had a better range of motion of knee, less period of immobilization, better psychological status six months after healing but had a higher risk of recurrence of infection.
Keywords
Infected Non-United Fracture Femur; One-Stage Protocol; Two-Stage Protocol
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