title: Management of Aseptic Tibial and Femoral Diaphyseal Nonunions Without Bony Defects.
abstract: An evidence-based description of aseptic tibial and femoral diaphyseal nonunions without segmental defects is based on a systematic search of MEDLINE. Aseptic nonunion of the femoral or tibial diaphysis without segmental defects and with an in situ nail, treated with reamed exchange nailing or augmentative plating and bone grafting, has consistently high union rates. Aseptic nonunion without segmental defects and with in situ plate and screw fixation is best managed with revision plate and screw fixation and autogenous bone graft. Various techniques and methods of biological stimulation have relatively high union rates.
authors.affiliation: Fondren Orthopedic Group LLP, Texas Orthopedic Hospital, 7401 South Main Street, Houston, TX 77030, USA; Department of Orthopaedic Surgery, The University of Texas Medical School at Houston, 6431 Fannin Street, Houston, TX 77030, USA.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Brinker
authors.affiliation: Department of Health and Human Performance, University of Houston, 3855 Holman GAR104, Houston, TX 77204-6015, USA. Electronic address: dpoconno@central.uh.edu.
authors.forename: Daniel P
authors.initials: DP
authors.lastname: O'Connor
mesh_terms: D001860:Bone Plates; D005264:Femoral Fractures / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D005594:Fracture Fixation, Intramedullary; D005599:Fractures, Ununited; D006801:Humans; D013978:Tibial Fractures / Q000601:surgery*
keywords: Augmentative plating; Bone graft; Exchange nailing; Fractures, Ununited; Revision surgery