Study of Factors Affecting the Clinical and Radiological Outcome in Management of Infected Non-Union of Tibia Managed with Ilizarov Ring Fixator and its Correlation with Patient-Reported Outcome: Prospective Descriptive Study

Background Non-union of fracture of tibia is often associated with multiple problems like infection, deformity, bone loss, and soft tissue loss. Ilizarov is a worldwide accepted treatment for infected non-union of tibia, but correlation of patient-rated outcome measures with surgeon-assessed clinical and radiological outcomes is not being done in the literature. Objectives To analyze the variables affecting clinical and radiological outcomes and patient-reported outcomes (EQ5D5L) and to assess correlation between patient-reported outcome measures and ASAMI scores during management of infected nonunion of tibia with Ilizarov ring fixator. Patients and methods Thirty three patients aged between 18 and 70 years, both sexes, presenting with infected non-union tibia. Results The mean age was 39.51 +/- 14.94 years +/- SD, pre-operative EQ5D5L score was > 20 in 87.9%, patients mean value is 21.061 +/- 3.508 SD, mean non-union severity score was 51.7 +/- 15.7 SD, mean Infection Severity Score is 44.485 +/- 18.755 SD. The correlation of the variables affecting the ASAMI radiological score: Distal 1/3rd and midshaft, Smoking, Alcohol, Non-union severity score, Infection severity score had negative correlation, with significant p value and EQ5D5L score immediate post-operative score and EQ5D5L follow up had positive correlation with ASAMI radiological score. Gap / bone loss score had negative correlation, p value being 0.058+. EQ5D5L immediate post-operative score and EQ5D5L follow up had positive correlation with significant p value with ASAMI clinical score. Conclusion Ilizarov fixator is an excellent tool in managing infected nonunion of tibia with bone loss with good patient rated outcome and ASAMI clinical and radiological score.