title: Distal tibial nonunion treated by intramedullary reaming with external immobilization.
abstract: Seventeen distal tibial nonunions were treated by a combination of metal removal with closed intramedullary reaming for internal bone graft and application of a long leg cast for aseptic nonunions and an external fixator for quiescent septic nonunions. The nonunions were present for a median of 1.8 years (range, 1.2-3.4 years). All achieved a solid union with a union period of 5.2 +/- 1.6 months. There was one complication of a renewed infection in a septic nonunion. The functional rating score improved from all unsatisfactory before treatment to 13 satisfactory after treatment. The other four (all were infected nonunions) also improved from poor to a fair outcome. In conclusion, the technique described is a simple and effective method to treat some complex distal tibial nonunions.
authors.affiliation: Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Taiwan, Republic of China.
authors.forename: C C
authors.initials: CC
authors.lastname: Wu
authors.forename: C H
authors.initials: CH
authors.lastname: Shih
mesh_terms: D000328:Adult; D016025:Bone Transplantation / Q000379:methods*; D002370:Casts, Surgical; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D017102:Fracture Healing; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome