Surgical treatment of non-unions: A case for internal fixation

Non-unions present a particular challenge to the fracture surgeon and are frequently underestimated by the average practitioner. Although the use of ring fixation techniques is gaining in popularity, there remains a definite role for the use of bone grafting and plate fixation within certain clinical situations. The role of decortication, or petalling, as part of the surgical approach, is emphasized. This review addresses the basic considerations in choosing to use internal fixation to manage non-unions and outlines some of the principles of these techniques. Case examples are presented.