IL TRATTAMENTO DELLE PSEUDOARTROSI INFETTE DI TIBIA CON PERDITA DI SOSTANZA OSSEA E DEI TESSUTI MOLLI MEDIANTE EPIDERMO-FASCIO-OSTEOPLASTICA

Tibial infected nonunions with loss of bone and soft tissues are still a very serious problem. Classical treatments and Papineau method demand long recovery times and present many possible complications. Good results achieved by compression-distraction methods are described by many authors, but in such series the problem of defect and infection of soft tissues is not completely described. Epidermato-fascial-osteoplastic technique permits a simultaneous bone and soft tissue regeneration, after a large resection of the necrotic and infected bone and soft tissues, without previous sterilization of the purulent foci or coverage of the soft tissues. An accurate debridement is carried out by wide resection of the exposed and infected bone and soft tissues. The wide debridement area is kept open. After metaphyseal corticotomy a gradual bone transport is performed. This connects the two bone ends and also the soft tissues around the bones, since the repositioning fragment trails the fascia and skin along with it. Results obtained in 8 patients treated with this technique are very satisfactory and allow to consider this methods as a valid alternative to traditional treatments.