Abstract
THE INCIDENCE of nonunion in fractures of the lower third of the tibia is greater than that in fracture of any of the other long bones. Among the various etiologic factors responsible for this condition are (1) poor local blood supply of the bone and (2) a relative lack of muscular and fascial tissues, with coaptation of fractures in this site. Furthermore, nonunion in this site may follow an inadequate period of immobilization. Surgical procedures, with their concomitant trauma, manipulation and introduction of metal screws and plates, will further reduce the local blood supply of bone and soft tissues. Although operative intervention may in the majority of instances result in good union without infection, still, because of the poor local blood supply, a percentage of fractures in this region so treated will be followed by nonunion, often with osteomyelitis. The latter condition may be caused by operative infection or by
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