[Treatment of tibial non-union with a large bone defect with half-tubular fibular graft, centromedullary nailing and bone graft].
BACKGROUND
Non-union is most frequent in the tibia. It may occur with bone loss and is most often seen in the mid-third, mainly as a result of high-energy trauma. Our purpose is to present a treatment alternative.


METHODS
Prospective, longitudinal, experimental trial conducted between 1999 and 2004. Five patients classified according to Judet and Paley were included. A half-tubular fibular graft plus an autologous and/or heterologous iliac crest graft were used with a UTN nail for stabilization purposes; mean follow-up was 24 months.


RESULTS
All patients were male. High energy trauma was the cause in 100%; 5 were Gustilo III fractures; Paley B1 type was present in 60%; the mean bone defect was 7.8 cm. Grade III Montoya bone healing was observed on average at 13.6 months. There were two complications; one infection that required removal of the synthesis without disrupting the healing, and one re-fracture which was managed at a different service.


CONCLUSIONS
An autologous half-tubular fibular graft, plus autologous and/or heterologous graft, stabilized with a UTN nail, restores the loss caused by the bone defect and allows achieving an appropriate bone healing.
Enríquez Castro
José Antonio
JA
Hospital General de México SS OD. drenriquezja@hotmail.com
López Valero
Atanasio
A
García Hernández
Antonio
A
Ynurreta Mancera
Jorge Armando Hernández
JA
Molina Méndez
Josefina
J
D000293:Adolescent; D000328:Adult; D001858:Bone Nails; D016025:Bone Transplantation; D005360:Fibula / Q000637:transplantation*; D005594:Fracture Fixation, Intramedullary; D005599:Fractures, Ununited / Q000601:surgery*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013978:Tibial Fractures / Q000601:surgery*