Lift your leg high to avoid catching your frame or ripping your sheets/mattress. You may have to change which side you sleep on depending on which leg you find easiest to lead with. Karger et al 55 reported a series of 84 cases, of which 50% were infected. Although union was obtained in 90%, this was after a mean of 6.11 interventions and a mean of 14.4 months after the first stage reconstruction. Furthermore, the authors advised that weight-bearing was delayed until union had been achieved at a mean of 17.4 months. Average frame times for bifocal compression/distraction and bone transport in our series were 9.4 and 10.7 months, respectively. Our patients are mostly able to weight bear at an early stage, which may prevent other complications, such as muscle wasting and disuse osteopenia. CONCLUSIONS Korobeinikov AA, Aranovich AM, Popkov DA. Ilizarov National Medical Research Centre for Traumatology and Orthopedics, Kurgan, Russia.

Hutson JJ. The treatment of distal tibia periarticular fractures with Ilizarov fixators. Tech Orthop. 2002;17(1):71–92. The frame can be very heavy, so your Occupational Therapist may provide equipment to make getting in and out of bed easier. Your physiotherapist will provide walking aids to allow you to mobilise from the first day after your operation, the aid used will vary depending how much support you require. It is advisable that you have pain relief prior to therapy input as this will allow you to get the most out of your time with the therapist. Prospective information was collected on demographics, comorbidities, associated deformity, microbiology and histology data from intraoperative sampling, the nonunion stiffness, complication rate, and outcomes during the treatment period and follow-up.All patients were assessed in a multidisciplinary clinic, comprising orthopaedic and plastic surgeons, infectious disease physicians, and a specialist Ilizarov nurse practitioner. Antibiotics were stopped at least 14 days before surgery to aid microbiologic diagnosis. Surgical Management and Microbiologic Sampling

Tsang et al 50 treated 32 infected tibial nonunions with exchange nailing but achieved success in only 35%, rising to 61.3% after 2 exchanges. They concluded that the Ilizarov method may be the preferred option in infected cases. Everyone heals at a different rate. The length of time you will need to wear your frame will likely be a minimum of 3 months. But in most cases patients must wear their frames for 6-12 months.The Limb Reconstruction Team consists of consultant orthopaedic surgeons, frame specialist nurse and specialist physiotherapist. What is a frame? Leave any crusts that form around the pins. If left the crusts are a natural barrier from infection. Extending skin incisions to release soft-tissue tension around the pin/wire insertion (see inspection and treatment of skin incisions)

The Ilizarov fixator provides efficient treatment for some of the most baffling conditions in orthopedic practice such as gap and infected nonunion of the tibia (14). Tibial non-unions are challenging to treat and are further complicated by bone loss 15 and infection. 16 The Ilizarov technique of distraction histogenesis allows removal of infected bone segments, stabilization, better chances of consolidation, and maintenance of limb length as well. It also allows joint function and thereby it is encouraged and started within few days of frame application. 17 The Ilizarov frame's adaptability to axial loading and resistance to torsional and bending forces further helps in achieving a limb that has fewer deformities and normal strength and range of motion. 1 , 2 You may have an intravenous drip in your arm. This can be removed when you are drinking, eating and have urinated.Twenty cases cultured coagulase-negative Staphylococci. Polymicrobial culture was present in 20 cases. Other organisms identified included; 9 methicillin-sensitive Staph. aureus, 4 methicillin-resistant Staph. aureus, 3 Pseudomonas spp., 3 Enterobacter cloacae, 2 Escherichia coli, 2 Klebsiella spp., 2 Enterococcus faecalis, 2 diphtheroids, 2 Streptococcus spp., 1 Proteus mirabilis, and 1 Morganella morganii. There were 8 cases with no significant growth but with a positive histology for infection or a sinus present. Ilizarov Method Monofocal distraction is the technique of choice in stiff, infected nonunions. Nonviable elements can be excised and distraction can be reliably used to promote union. It offers real advantages for correction of deformity and shortening, with acceptable fixator times. Monofocal compression has a limited place in the management of infected nonunion, and we do not recommend it in nonviable, mobile nonunions.