Management of aseptic non-unions of the distal third of the tibial diaphysis using static interlocking intramedullary nailing.
OBJECTIVE
To evaluate the management of aseptic non-unions of the distal third of the tibial diaphysis, using static interlocking intramedullary nailing.


METHODS
Between January 2005 and November 2012, a total number of 42 patients who underwent surgery at our hospital for aseptic non-unions of the distal third of the tibial diaphysis, were included in our study. Preoperatively, all the patients were tested for the presence of infection of non-union. The post-operative follow up was based on clinical and radiological findings.


RESULTS
Union was achieved in 41 (98%) patients, at a mean time of 5.8 months (four-eight months). One (2%) patient developed infection of the wound four weeks after the operation. A small decrease of the tibial length, of about one cm was seen in three (7%) patients. Pain of the patellar tendon, at the entry point of the nail, was observed in six (14%) patients, without impacting the range of motion of the knee. In two (5%) patients, a decrease in dorsiflexion of the ankle joint occurred, of about ten degrees angle.


CONCLUSIONS
Static interlocking intramedullary nailing is the preferable technique in the management of aseptic non-unions of the distal third of the tibial diaphysis, because it provides high union rate and few postoperative complications. A good preoperative evaluation for infections, use of proper surgical technique with respect to soft tissues, use of autogenous bone grafts and early mobilization of patients, are the keys to success of this method.
1Department of Orthopaedics, Asclepieion Voulas General Hospital, Athens, 2Department of Orthopaedics, Argos General Hospital; Greece.
Dimitrios
D
Begkas
Dimitrios
D
Katsenis
Alexandros
A
Pastroudis
D000293:Adolescent; D000328:Adult; D001858:Bone Nails; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D005599:Fractures, Ununited / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013978:Tibial Fractures / Q000601:surgery*; D055815:Young Adult