J Korean Fract Soc.  1998 Jul;11(3):552-559. 10.12671/jksf.1998.11.3.552.

Treatments of the delayed Union or Nonunion of Tibial Shaft Fracture Fixed with Interlocking IM nail

• Park YB
• Hwang CS
• Chung PH
• Kang S
• Chae DJ
• Kim HC
• Moon SH
• Kim JP
• Kim DJ

• KMID: 1943969
• DOI: http://doi.org/10.12671/jksf.1998.11.3.552

Abstract

Interlocking intramedullary nailing has been the first choice treatment of most tibial shaft fractures because its rigidity of fixation allows early ROM and weight bearing. Although most interlocking nailing procedures are performed with closed reduction that preserve periosteal blood supply, delayed union or nonunion is often occurs. so secondary procedures, such as bone graft, dynamization, nail exchange, are necessary to achieve fracture healing. We analyzed 25 cases of delayed union or nonunion from 432 tibial shaft fractures fixed initially with static interlocking intramedullary nailing since January 1990 till January 1996. Overall incidence of delayed union or nonunion is 5.8%(25/432). Secondary procedures included mainly iliac bone graft or dynamization. Average time to achieve bone union after secondary procedure is 6.1 months. The more distracted or displaced fracture ends after interlocking nailing or the more comminuted fracture fragments led to the more delayed bone union. Careful attention to minimize distraction or displacement during interlocking nailing is necesary to decrease the incidence of delayed union or nonunion. And appropriate procedures should be performed when delayed union or nonunion is predicted, which result in success in most cases.

Keyword

Tibia; Delayed union or Nonunion; Interlocking IM nail; Bone Graft; Dynamization

MeSH Terms

Fracture Fixation, Intramedullary
Fracture Healing
Fractures, Comminuted
Incidence
Tibia
Transplants
Weight-Bearing