EVALUATION OF ROLE OF LIMB RECONSTRUCTION SYSTEM FIXATOR (LRS) IN MANAGEMENT OF NONUNION TIBIA WITH IMPLANT FAILURE

Introduction; The management of non-unions tibia pose many challenge to the orthopedic surgeons. Challenges include recalcitrant infection, complex deformities, sclerotic bone ends, large bone gaps, shortening, and joint stiffness. Improper management leads to multiple surgeries and disability in patients. The ASAMI classification helps decide treatment. Co-morbid factors such as smoking, diabetes, non steroidal anti-inflammatory drug use, and hypo vitaminosis D influence the choice and duration of treatment External fixation using limb reconstruction system (LRS) is one of the options in the management of these conditions. Compression at nonunion site achieves union. It can be combined with a corticotomy at a distant site for equalization. Soft tissue deficit has to be covered by flaps, either local or microvascular. Bone gaps are best filled with the reliable technique of bone transport. Regenerate bone may be formed proximally, distally, or at both sites. Acute compression can fill bone gaps and may need a fibular resection. When bone ends dock, union may be achieved by vertical or horizontal compression. We are presenting a series of 03 cases Case Series; of non-union tibia with implant failure managed with LRS fixator. 02 patients were managed initially with AO external fixator, one with plating. Out of three cases, two cases were non infected non unions and one case was infective non unions. All the three patients were managed secondarily with LRS fixator with less complications and good outcome. Conclusion; LRS fixator is one of the best options in the management of both infective and non-infective non unions of the tibia. It helps in both compression and distraction in a single frame with minimal complications. It gives good stability in the bone which helps in early weight bearing and adjacent joint range of motion