Nonunion of tibial fractures treated with external fixation. Contributing factors studied in 71 fractures

We analyzed factors of importance for nonunion in a series of 39 closed and 32 open fractures of the tibia which were treated with external fixation. Factors analyzed included, age and sex of the patients, the mechanism of injury, the amount of soft tissue damage, the grade of comminution, the level at which the tibia was fractured, the presence of an intact fibula, the presence of multiple injuries, the type of external fixation used (Orthofix, STAR-90 or Hoffmann) and the need to supplement the stability of the reduction. We found that the type of open fracture, comminution of the fracture, extension the original wound for satisfactory reduction and fracture of the ipsilateral fibula, played a role in the development of nonunion.