title: One-stage reconstruction with open bone grafting and vacuum-assisted closure for infected tibial non-union.
abstract: BACKGROUND
  Non-union of the tibia complicated by osteomyelitis is one of the most challenging problems in orthopaedic surgery. There remains a significant amount of debate and controversy regarding the optimal medical management of infected tibial non-union. There are few articles which have reported the outcomes of treatment for infected non-union of tibia from single-stage reconstruction with open bone grafting plus vacuum-assisted closure (VAC).
  
  
  METHODS
  Our report covers experience between March 2007 and February 2010 of open bone grafting plus VAC in one stage for patients with infected tibial non-union. The time for bone union and wound healing to occur, the duration of hospitalisation, and the rate of resolution of infection were all analysed. The main outcome measures were based on a clinical scoring system that assessed functional ability, range of knee and ankle motion, shortening, infection and pain. Fifteen patients were involved in this study.
  
  
  RESULTS
  All patients were followed up for an average of 22.6 months (range: 14-42 months). Bone union was achieved in 93.3% (14/15) of patients after a mean of 5.93 months (range: 3-10 months). All wounds healed within an average period of 5 weeks (range: 3-10 weeks), and the function and appearance of all limbs were satisfactory.
  
  
  CONCLUSIONS
  Open bone grafting combined with VAC in a one-stage procedure can be a feasible alternative to the treatment of infected tibial non-union, especially for those wounds which are not good candidates for microsurgery; however, further studies are required to confirm the likely benefits.
authors.affiliation: Department of Orthopaedics, Zhongnan Hospital of Wuhan University, Wuhan, China.
authors.forename: Zhouming
authors.initials: Z
authors.lastname: Deng
authors.affiliation: Department of Orthopaedics, Zhongnan Hospital of Wuhan University, Wuhan, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Cai
authors.affiliation: Department of Orthopaedics, Zhongnan Hospital of Wuhan University, Wuhan, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Jin
authors.affiliation: Department of Orthopaedics, Zhongnan Hospital of Wuhan University, Wuhan, China.
authors.forename: Ansong
authors.initials: A
authors.lastname: Ping
authors.affiliation: Department of Orthopaedics, Zhongnan Hospital of Wuhan University, Wuhan, China.
authors.forename: Renxiong
authors.initials: R
authors.lastname: Wei
keywords: Papineau technique; infected; tibial non-union; vacuum-assisted closure