Infected nonunion of the femur and tibia

The data presented in this article support the view that first saucerizing the infected bone and then grafting give good results. Immediate bone grafting, that is, bone grafting within a few days or weeks of saucerization, will fail when insufficient care has been employed in preparing the area for bone grafting. Using finely divided cancellous bone combined with a suitable fixator is important. Treatment of a nonunion can be successful without bone grafting if, after complete saucerization, stability is achieved by a brace, cast, or external fixator. Failure in all categories of patients is, in the main, due to failure to control the infection or inadequate stabilization. Posterolateral bone grafting may be an excellent alternative and was used in 20 per cent of the patients with tibial nonunion and a substantial loss of tibial shaft.