Abstract
Background and objectives: Nonunion following diaphyseal tibial fractures is still a challenging problem facing orthopaedic practice , different approaches used to tackle this problem , the aim of this study was to evaluate the outcome of treatment by non cannulated intramedullary nailing as regards union and complications Method: Eighteen patients with non-united diaphyseal tibial fractures their age ranged between 19 –60 years (mean of 33.5 years) were studied and treated by non cannulated intramedullary nailing between 2005 to 2010. Initially all these patients underwent multiple surgeries including wound excisions , revision of fixation and bone grafting All underwent fixation by non cannulated intramedullary nailing , in 14 patients , the site of the non-union wasexplored to correct alignment by osteotomy , while closed intramedullary nailing were performed in the remaining 4 patients Results: In seventeen cases ( 94.4 % ) union was achieved between 5 – 9 months with an average of 7.5 months , complications included refracture and failure of fixation in 1 patient ( 5.6 % ) and superficial wound infection occurred in 3 cases ( 16.6 % )Patients with nonunited diaphyseal fractures were followed post-operatively for 1 – 6 year( average 4 years ) , eventually healing was successful with full weight bearing without support and pain , fracture line was not visible on radiographs Conclusion: Non-cannulated intra-medullary nailing appears to be very helpful procedure to promote union in these cases with relatively less significant complications .
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