{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T17:26:03Z","timestamp":1778952363655,"version":"3.51.4"},"reference-count":18,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,12,20]]},"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:p>A 19-year-old morbidly obese man presented with infected nonunion of femoral shaft fracture. Patient had history of 13 failed fixation surgeries, assessment revealed 3-centimetre limb-length discrepancy with 3-centimetre gap nonunion. Wound debridement, primary compression and external fixation using a customised Ilizarov external fixation assembly were planned. A four-ring customised assembly was applied. Partial weight bearing was allowed from first postoperative day on walker. Patient was kept on a monthly follow-up. After complete union at 10 months after surgery, frame was dynamised. After 6 months of dynamisation, frame was removed, at that time patient was full weight bearing. Knee was still stiff with a range of motion of 0\u00b0\u201320\u00b0, and there was 6 cm of limb length discrepancy, which was managed with a shoe raise. At 9 months after frame removal, patient is mobile with fully united bone. Ilizarov external fixator can be a good managing option in such difficult and complicated cases.<\/jats:p>","DOI":"10.1136\/bcr-2021-245824","type":"journal-article","created":{"date-parts":[[2022,1,18]],"date-time":"2022-01-18T10:52:48Z","timestamp":1642503168000},"page":"e245824","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Management of femoral shaft infected nonunion through customised Ilizarov external fixator assembly in a morbidly obese patient"],"prefix":"10.1136","volume":"15","author":[{"given":"Muhammad Saad","family":"Ilyas","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Spine Surgery, Ghurki Trust Teaching Hospital, Lahore, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdul","family":"Sattar","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Spine Surgery, Ghurki Trust Teaching Hospital, Lahore, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3051-4200","authenticated-orcid":false,"given":"Uruj","family":"Zehra","sequence":"additional","affiliation":[{"name":"Department of Anatomy, University of Health Sciences, Lahore, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amer","family":"Aziz","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Spine Surgery, Ghurki Trust Teaching Hospital, Lahore, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,1,18]]},"reference":[{"key":"2025082623411806000_15.1.e245824.1","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.ocl.2010.07.004","article-title":"Management of femur shaft fractures in obese patients","volume":"42","author":"Streubel","year":"2011","journal-title":"Orthop Clin North 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