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Selected Instructional Course Lecture   |    
Delayed Unions of the Tibia
Laura S. Phieffer, MD1; James A. Goulet, MD2
1 Department of Orthopaedic Surgery, The Ohio State University, N1037 Doan Hall, 410 West 10th Avenue, Columbus, OH 43210
2 Department of Orthopaedic Surgery, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0328
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The authors did not receive grants or outside funding in support of their research for or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.
Printed with permission of the American Academy of Orthopaedic Surgeons. This article, as well as other lectures presented at the Academy's Annual Meeting, will be available in March 2006 in Instructional Course Lectures, Volume 55. The complete volume can be ordered online at www.aaos.org, or by calling 800-626-6726 (8 a.m.-5 p.m., Central time).
An Instructional Course Lecture, American Academy of Orthopaedic Surgeons

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2006 Jan 01;88(1):205-216
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Extract

Nonunion of the tibial shaft is a common problem that can be disabling. Treatment may require multiple operative procedures, prolonged hospitalization, and years of disability before a union is obtained or an amputation is performed. Most tibial fractures heal after the initial treatment1-4, but nonunion is seen by all practitioners who treat tibial fractures. Early recognition of a potential nonunion followed by early intervention will reduce the ultimate time to union and lessen the surgeon's and patient's frustration. This Instructional Course Lecture provides an overview of tibial delayed unions and the treatment options available to manage this diverse group of clinical problems. We believe that most tibial nonunions can be treated by most orthopaedic surgeons without referral.
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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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