Abstract

• It is often difficult to achieve bony union in the cases of nonunion of the fractured tibia. The frequency of nonunion of tibial shaft is increasing due to an increment of open, commi noted fractures, associated soft tissue injuries and association of visceral ruptures, and so its treatments give orthopedic surgeons a rather difficult obstacles.
  9 cases of nonunion of tibial shaft were treated from Jan., 1988 to Dec., 1992 and the average folllow up period was 11.6 months with minimal 9 months and maximum 17 months, and the results were as follows:
  1. Of the 9 patients, there were 7 male and 2 female patients.
  2. The cause of the fractures was traffic accident, all of 9.
  3. Of the 9 cases, there were 6 open and 3 closed fractures.
  4. The shape of fractures consisted of 3 comminuted, 3 segmental, 2 oblique, 1 transverse.
  5. At the time of initial treatemt, 5 were treated operatively, 4 were treated conseuatively
  6. Of the 3 associated injuries, there was 1 pelvic bone fracture, 1 multiple rib fracture with pneumo-hemothorax, 1 head injury.
  7. Average period from injury to diagnosis as nonunion was 9.3 months.
  8. Of the probable causes of nonunion, 5 cases were caused by inadeauate or inappropriate immobilization, 2 by bone defect, 1 by infection, 1 by implant failure.
  9. The average time required for union was 6.4 months in hypertrophic nonunion and 8.8 months in atrophic nonunion.
• Key words: Fracture, Nonunion, Tibial shaft

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