Your ability to go to the shops will depend on your level of mobility. Being able to attend the shop for groceries should be a goal of yours if you were able to do this before. Initially for convenience, you may wish to speak to friends or family about arranging assistance. You will also see an anaesthetist who will examine you and discuss pain relief medication and other important factors related to giving you an anaesthetic. The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means: Paley, Dror; Kovelman, Harry F; Herzenberg, John E (October 1993). "Ilizarov technology". In Stauffer, Richard (ed.). Advances in Operative Orthopaedics: Volume 1 (PDF). Mosby Inc. pp.243–287. ISBN 978-0-8151-7939-9. Archived from the original (PDF) on 19 March 2012 . Retrieved 14 January 2012. For more robust tasks such as hoovering or changing the bedding, you may want to arrange help. Speak to friends and family about this, or if you are able, privately arrange a cleaner.

The compression group had the poorest outcomes, with fewer patients achieving a rating of “excellent” or “good” in the bone and functional classifications (52.6% and 63.2%, respectively). This compares to 96.2% and 100% for the distraction group, 81.3% and 93.8% for the compression/distraction group, and 77.8% and 94.4% for the bone transport group. This difference was statistically significant in both the bone and functional domains ( P = 0.0017 and 0.00006). All patients are at risk of having skin infections around the entry points of the wires and pins, if this occurs it is treated with a short course of antibiotics. Occasionally patients have to take a longer course of antibiotics, sometimes for the duration of their frame treatment. Very rarely the infection can affect the bone or joint; this is called osteomyelitis or septic arthritis. This often requires further surgery and a long course of antibiotics which are usually administered intravenously (into a vein). Step your frame leg first then weight bear down through your arms and step your non-operated leg in to meet it then repeat. 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 Extending skin incisions to release soft-tissue tension around the pin/wire insertion (see inspection and treatment of skin incisions)Ilizarov taught that, “infection burns in the flame of regeneration.” In our series, infection was eradicated in all 60 of the cases involving distraction, but this may be due to better removal of the infected tissue with a larger resection gap compared with the monofocal compression group. Reliable clearance of infection in the bifocal group offers a significant advantage, allowing safer bone grafting and internal fixation if union is not secured by the Ilizarov method alone. It will take you some time to adjust to the practicalities of living with the frame by making adjustments to clothing, your sleeping position and daily activities. Before you go home we will make sure you know how to look after your frame and signs of any complications that you need to look out for. How do I prepare for the frame? To prevent postoperative complications, pin/wire-insertion technique is more important than any pin/wire-care protocol: We present the largest series of infected tibial nonunions, treated using an algorithm, designed to help in decision making of Ilizarov strategy. 13,14,19 We have defined indications for each Ilizarov treatment protocol (monofocal distraction, monofocal compression, bifocal compression/distraction, and bone transport) based on the biologic and mechanical requirements of each infected nonunion.

Korobeinikov AA, Aranovich AM, Popkov DA. Ilizarov National Medical Research Centre for Traumatology and Orthopedics, Kurgan, Russia. The Limb Reconstruction Team consists of consultant orthopaedic surgeons, frame specialist nurse and specialist physiotherapist. What is a frame? The management of infected nonunion of the tibia is challenging, particularly with segmental bone loss, multiple draining sinuses, poor soft tissue cover, osteopenia, adjacent joint stiffness, limb deformity, or multidrug-resistant polymicrobial infection. 1,2 Permanent functional deficits, prolonged recovery times, and even amputation can result. 3 Despite acceptance of open fracture management guidelines, advances in implant design, and less traumatic surgical techniques, infection is still common after open fracture (9.3%–18%). 4–8 Studies have demonstrated financial costs to be 2 to 3 times higher for infected fractures compared with cases uncomplicated by infection. 9,10 Bianchi Maiocchi A, Aronson J. Operative principles of Ilizaov fracture treatment, no union, osteomyelitis, lengthening, deformity correction. Baltimore: Williams & Williams; 1991. NHS SUPPLIED ILIZAROV FRAME COVER – Designed in association with specialist UK clinicians, the SOLACE BRACING Breathable Ilizarov Frame Cover is the leading apparatus cover for the NHS. With a primary focus of infection prevention and protection, our Ilizarov Frame Cover is the ideal healing companion for your post-surgery recuperation. Start your journey to recovery today with this advanced external fixator cover by SOLACE BRACING.

Ilizarov Principles of Deformity Correction”, Annals of the Royal College of Surgeons of England 2010; 92: 101. It is very important that you attend your physiotherapy appointments, do your exercises and wear your foot splint when you are resting; this is to prevent joint contracture, stiffness or dislocations. These problems are more common in patients having multiple deformity correction or lengthening surgeries. Delayed Union and Non-Union In all patients, skin closure was achieved in the same operation, either directly or using local or free microvascular muscle flaps to restore a healthy soft tissue envelope. Postoperative Care If you find this is difficult and your toes remain in a bent position try to gently straighten them out with your hands – hold this stretch for 30 seconds and repeat 3-5 times.