J Korean Fract Soc.  2023 Oct;36(4):125-132. 10.12671/jkfs.2023.36.4.125.

Treatment Results of Reamed Exchange Nailing in Aseptic Nonunion of Tibial Shaft Fracture

• Cho Y
• Lee JY
• Ryu J
• Kim HT
• Moon JJ

• KMID: 2547296
• DOI: http://doi.org/10.12671/jkfs.2023.36.4.125

Abstract

Purpose
Intramedullary nailing is used widely for treating tibial diaphysis fractures because of its relatively rigid internal fixation, which allows weight bearing, resulting in rapid bone healing and functional recovery. This study evaluated the results of exchange nailing in treating aseptic nonunion of tibial shaft fractures.
Materials and Methods
From November 2015 to December 2021, a retrospective study was conducted on patients who had undergone intramedullary nailing for tibial diaphysis fractures. Among them, this study focused on patients diagnosed with nonunion and who underwent exchange nailing. Twenty patients with a minimum follow-up period of at least 12 months were included in the study.
Results
The mean ages of patients were 60 years (range, 30-79 years). Of the 20 cases in which exchange nailing was performed, bone union was achieved in 18 cases (90.0%), and the mean period was 23 weeks (range, 14-46 weeks). Among the 18 cases of bone union, one case exhibited delayed union and achieved union without additional treatment after 46 weeks, while two cases of nonunion failed to achieve union and were lost to follow-up until the final assessment.
Conclusion
Reamed exchange nailing performed on aseptic nonunion after intramedullary nailing for tibial diaphysis fractures had satisfactory clinical outcomes.

Keyword

Aseptic nonunion; Exchange nailing; Tibial diaphysis fracture