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Tibial diaphyseal nonunions after external fixation treated with nonreamed solid core nails
B L Riemer1, S Sagiv, S L Butterfield
1Department of Orthopedic Surgery, Medical College of Pennsylvania, Pittsburgh, USA.
Orthopedics
|February 1, 1996
Summary
Nonreamed solid core nailing effectively treats tibial diaphyseal nonunions after external fixation, with high union rates and manageable complications. This method offers a viable solution for complex fracture cases.
Area of Science:
- Orthopedic Surgery
- Traumatology
- Bone Healing
Background:
- Tibial diaphyseal fractures often require external fixation.
- Nonunion can occur after initial fracture treatment.
- Management of tibial nonunion post-external fixation presents challenges.
Purpose of the Study:
- To evaluate the efficacy of nonreamed solid core nailing for tibial diaphyseal nonunions.
- To assess union rates and complication profiles.
- To determine the safety and effectiveness of this technique after external fixation.
Main Methods:
- Retrospective review of 29 patients with tibial diaphyseal nonunion (> 22 weeks).
- Treatment involved nonreamed solid core nailing (Alta, Lottes, Rush nails).
- Analysis of fracture union, duration of treatment, and complications.
Main Results:
- Twenty-seven of 29 fractures united, with an average healing time of 14 weeks.
- One patient required reamed exchange nailing, and one had persistent asymptomatic nonunion.
- Pre-nail deformities and infections were addressed, with most infections treated successfully prior to nailing.
Conclusions:
- Nonreamed solid core nailing is an acceptable treatment for tibial diaphyseal nonunions following external fixation.
- The technique demonstrates a high success rate for fracture healing.
- Complications, including infection and deformity, can be managed effectively.