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While approximately 80-90% bone healing occurs after fractures; bone healing may not be achieved for the rest of the cases due to bone status, surgery conditions and performed surgical method or patient related reasons. In addition, bone segment losses due to multiple previous surgeries and infection (osteomyelitis) may concur and for these cases, treatment is harder. Especially, if infection accompanies long bone pseudoarthrosis such as femur and tibia, the treatment becomes problematic for both the patient and the surgeon.

We generally choose two-step treatment method for infected pseudoarthrosis patients. The first step is to excise the infected, non-healing, dead bone region completely and to restore viable bone. Afterwards, in order to treat infection thoroughly, beads made of antibiotic cement is put and the surgery is concluded. During the follow-up, patient is controlled clinically and with laboratory studies (i.e. CRP, ESR, leucocyte count). The second step surgery is performed after the infection is eradicated. In the second step, beads are removed and the region is debrided. Afterwards, Ilizarov method is used to achieve bone healing and limb lengthening from another healthy site and limb length discrepancy is eliminated.

Patient 1: Patient with infected pseudoarthrosis of tibia who had been treated with surgery for 3 times previously at another center, the first step is the excision of the 8cm-long nonviable bone and antibiotic bead administration and after 2 months the second step with Ilizarov method was performed. The patient looks so healthy following the our treatment.

Patient 2: The result of two-step treatment for infected pseudoarthrosis of tibia at another patient which involved tibia.

Patient 3: The patient with infected pseudoarthrosis of femur who had been treated with surgery for 9 times; the successful result of two-step treatment