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Open intramedullary nailing and bone-grafting for non-union of tibial diaphyseal fracture
EE Johnson; RA Marder
J Bone Joint Surg Am, 1987 Mar 01;69(3):375-380
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Abstract

Twenty consecutive patients who had non-union of twenty-two fractures (two of the patients had a segmental fracture) of the tibia underwent open reduction, debridement, and intramedullary nailing that was supplemented by bone-grafting with either autogenous cancellous iliac bone or cortical reamings of bone from the intramedullary canal. Eighteen patients had significant deformity associated with the tibial fracture. All but three patients had postoperative splinting for two to four weeks, followed by walking without a brace; the three patients who did not have postoperative splinting were more than sixty-five years old. All of the fractures went on to union. Two patients had a minor complication that did not affect the final result. Incorporation of callus across the site of non-union occurred at a rapid rate. Anatomical alignment of the tibial shaft was obtained in nineteen of the twenty patients.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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