Non union long bones treated with rigid fixation and autogenous bone grafting. A Series of 50 Cases

Abstract

Introduction: The surgical treatment of aseptic nonunion often represents a more challenging situation for the orthopaedic surgeon than treatment of the primary fracture. In fact, it may be necessary not only to ―rivitalize‖ the nonunion area, but also to exchange the bone fixationdevices and to place some refill material in the bone gap. Objective: To study the Non-union long bones treated with rigid fixation and autogenous bone grafting. Materials and methods: We present the results of 50 cases of long bone nonunion that have been treated in a period of 3 years (2011–2013) by open approach to the nonunion site with autologous bone graft interposition. The site 11humerus, 9 forearms, 12 femurs, 18 tibias and the type of nonunion (42 atrophic, 8 hypertrophic) was considered in the surgical planning as were the mechanic and biological problems. Newosteosynthesis was performed in50 cases: with plate and screws in 29 cases, with intramedullary nails in 16 cases, with external fixators in 2 cases and with only bone grafting in 3 cases. Bone graft, always autologous from the iliac crest was used in 48 cases and fibula with iliac graft was used in 2 cases. Result: Healing of the nonunion was successful in 49cases in a mean time of 9.8 weeks with few complications which was easily manageable and did not hinder the functional result. Conclusion: Autogenous Cortico-Cancellous Bone graft & Rigid Fixation still Gold Standard Treatment for Non-Unions in the era of Vascularised Bone Grafts.