Bone graft and plating of non-union after open tibial fractures

Abstract EN

Twenty five non-unions of the tibia (in twenty four patients) were initially treated by external fixation or pin & plaster and immobilization in a cast & bone grafting then they were treated by graft and plating.

There were 23 open fractures and 2 closed fractures with compartment syndrome.

Eleven non-unions (44%) had early soft-tissue reconstruction.

The duration of external fixation was average ten weeks and the mean time from injury to plating ten weeks and the mean time from injury to plating was eight months.

None of the non-unions were infected at the time of plating.

The average preoperative deformity in the sagittal (anterior-posterior) plane was 8 degrees and in the frontal (medical-lateral) plane 9 degrees.

After fixation, the residual angulations averaged 3 and 2 degrees respectively.

Autogenous bone grafting was used in all cases. The patients were followed for an average of twenty-four months.

23 (92%) of the non-unions united in an average of seven months without further intervention.

In 2 patients (8%), the plate broke, necessitating re-plating.

A deep infection developed in 2 patients (8%).

Ultimately, 24 non-unions (96%) healed without evidence of infection. Plate osteosynthesis is an effective method of treatment for patients who have had an open fracture of the tibia and has failed to unite after external fixation, pin and plaster or immobilization in a cast.