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Locked nailing for nonunion of the tibia
1Rowley Bristow Orthopaedic Unit, St Peter's Hospital, Chertsey, Surrey, England.
Summary
Locked intramedullary nailing effectively treated tibial shaft fracture nonunion in 24 patients. This method achieved high union rates and allowed early mobilization without external support.
Area of Science:
- Orthopedic Surgery
- Traumatology
Background:
- Nonunion of tibial shaft fractures presents a significant clinical challenge.
- Intramedullary nailing is a common surgical approach for tibial fractures.
Purpose of the Study:
- To evaluate the efficacy of locked intramedullary nailing for treating tibial shaft fracture nonunion.
- To compare outcomes between open and closed nailing techniques.
Main Methods:
- A cohort of 24 patients with tibial shaft fracture nonunion underwent locked intramedullary nailing.
- The procedure was performed using either open (18 patients) or closed (6 patients) techniques.
Main Results:
- Union was achieved in 22 out of 24 patients (91.7%).
- Failure occurred in two patients with active infection.
- Locked nailing effectively prevented deformity recurrence and enabled mobilization without external support.
- Bone grafting was necessary only for significant bone defects.
Conclusions:
- Locked intramedullary nailing is a successful treatment for tibial shaft fracture nonunion.
- The technique offers stability, prevents deformity, and facilitates early patient mobilization.
- Bone grafting should be reserved for cases with major bone loss.