Non-union in open tibial fractures.
This is a retrospective study of 104 open fractures of the tibial shaft seen at a civilian teaching center. Seventy-one per cent of the fractures resulted from vehicular accidents. Twenty-seven per cent of the fractures did not unite and half of these non-unions were infected. Virtually all of the ununited tibial fractures were associated with fractures of the fibula and with extensive avulsions of skin and dirty wounds. Although a variety of techniques for care of the wound and treatment of the fracture was used, none was entirely successful. Some failures were attributable to inadequacies of wound care--either premature primary closure or failure to perform secondary skin closure. Other failures of treatment were associated with use of internal fixation. Early weight-bearing without internal fixation, however, did not uniformly result in union.
D000063:Accidents, Traffic; D001696:Biomechanical Phenomena; D005592:Fracture Fixation / Q000379:methods; D005593:Fracture Fixation, Internal; D005597:Fractures, Open; D005599:Fractures, Ununited; D006801:Humans; D013714:Tennessee; D013978:Tibial Fractures / Q000503:physiopathology* / Q000601:surgery; D014945:Wound Healing