title: Exchange reamed nailing for aseptic nonunion of the tibia.
abstract: BACKGROUND
  Exchange reamed nailing of the tibia is a common procedure in the treatment of an aseptic tibial nonunion. However, reports in the literature supporting this technique are limited.
  
  
  METHODS
  Forty patients with a tibial nonunion after initial unreamed intramedullary nailing were retrospectively assessed after an exchange reamed nailing. The main outcome measurements included radiographic and clinical union as well as time from exchange reamed nailing to union.
  
  
  RESULTS
  Thirty-eight patients achieved union of their fracture (95%). The average time from exchange nailing to union was 29 +/- 21 weeks. Complications included one deep vein thrombosis (2.5%) and two hardware failures (5%).
  
  
  CONCLUSIONS
  Exchange reamed nailing for nonunions of the tibia results in a high union rate and is associated with a low complication rate. This technique is recommended as a standard procedure for aseptic tibial nonunions after initial unreamed intramedullary nailing.
authors.affiliation: Department of Orthopaedic Surgery, Division of Orthopaedic Traumatology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA.
authors.forename: Boris A
authors.initials: BA
authors.lastname: Zelle
authors.forename: Gary S
authors.initials: GS
authors.lastname: Gruen
authors.forename: Brian
authors.initials: B
authors.lastname: Klatt
authors.forename: Marcus J
authors.initials: MJ
authors.lastname: Haemmerle
authors.forename: William J
authors.initials: WJ
authors.lastname: Rosenblum
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Prayson
mesh_terms: D000293:Adolescent; D000328:Adult; D001858:Bone Nails; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation* / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D005597:Fractures, Open / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery; D005599:Fractures, Ununited / Q000382:microbiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D016896:Treatment Outcome