title: Treatment of infected nonunion and delayed union of tibia fractures with locking intramedullary nails.
abstract: Treatment of infected nonunion of tibial fractures has focused on irradicating infection before attempting to secure union. To secure union in the presence of infection in cases not amenable to conventional treatment, intramedullary nailing combined with open wound management was the treatment in 19 fractures of infected tibial nonunions in 18 patients. Eighteen fractures united. Drainage lessened or ceased after union of fractures and/or removal of nails. Only three cases had bone grafts. All were initially Type III open fractures. The majority occurred in motorcycle accidents. Time to union averaged 6.6 months (range, three to 14 months). Fourteen cases (15 tibias) healed without further drainage; four had minimal but persistent drainage. In properly selected cases, the treatment was safe and effective.
authors.affiliation: Division of Orthopaedic Surgery, University of Alabama at Birmingham.
authors.forename: M E
authors.initials: ME
authors.lastname: Miller
authors.forename: J R
authors.initials: JR
authors.lastname: Ada
authors.forename: L X
authors.initials: LX
authors.lastname: Webb
mesh_terms: D000293:Adolescent; D000328:Adult; D001858:Bone Nails; D005260:Female; D005597:Fractures, Open / Q000150:complications / Q000601:surgery*; D005599:Fractures, Ununited / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D010019:Osteomyelitis / Q000209:etiology / Q000601:surgery*; D011859:Radiography; D013203:Staphylococcal Infections; D013978:Tibial Fractures / Q000150:complications / Q000601:surgery*