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Aseptic nonunion of the tibia treated by plating and bone grafting: retrospective study about 40 cases
Khalid Chmali1, Mohammed ElIdrissi2, Hatim Abid2
1Surgery Department, CHP La Marche Verte, Boulemane, Morocco. khalidabdo55@gmail.com.
Objective:
The objective of this study was to evaluate the clinical and radiological results of the treatment of aseptic nonunion of the tibia by plating and bone grafting.
Material And Methods:
This retrospective study included 40 patients with aseptic nonunion of the tibia, treated in the Trauma-Orthopedic department B4 of CHU Hassan II in Fez-Morocco. The average age was 41 years (range 25-60 years). The initial fractures were in the middle third of the tibia for the majority of our patients. We used the ASAMI criteria to assess the results.
Results:
We found 45 patients with aseptic nonunion of the tibia who were treated by the same surgical team and followed in postoperative consultation for a fixed period of 10 months. Three patients lost to follow-up and two patients refused the treatment. In 37 patients (92.5%), union was obtained after a mean delay of 4.3 months (range 3-7 months). The average time from initial treatment to treatment for nonunion was eight months (range 6-10 months). According to the ASAMI classification, bone results were excellent in 26, good in 8, fair in 3 and poor in 3; functional results were excellent in 10, good in 16, fair in 11 and poor in 3.
Conclusions:
Our study suggests that the combination of screwed plate and autograft in the treatment of aseptic nonunion of the tibia has provided satisfactory results. A well-codified management of the initial fracture remains the gold key to prevent the occurrence of pseudarthrosis.
