Qaiser Faheem, Ashraf Nizami, Faraz Ahmed.
Outcome of different surgical techniques in the management of non-union tibia.
J Pak Orthop Assoc Jan ;22(1):87-91.

OBJECTIVE: To Study the rate of union using different techniques, their outcome and complications in tibial nonunion. STUDY DESIGN: It is a descriptive study. PLACE AND DURATION OF STUDY: From December 2007 for one calendar surgical techniques to Sharif Social Security Teaching Hospital, Lahore. PATIENTS AND METHODS: 32 patients with non-union tibia underwent different surgical techniques to achieve union and were retrospectively reviewed. 12 patients were treated with external fixation, 7 with plates and screw, 6 with static interlocking nail and 7 with plaster of Paris cast. Bone graft from the iliac crest was used in 6 patients and fibular segmental resection was performed in 6 patients. RESULTS: Solid Union was achieved in 30 patients over a period of 16 month. One patient developed transient peroneal nerve palsy which recovered after 3 month, one presented with equinous foot and in one compartment syndrome developed, which was managed by fasciotomy. CONCLUSION: We believe that external fixation with compression device is best for infected hypertrophic non unions, and added bone graft for atrophic non unions and in case of non-infected non-union, interlocking nail, compression plate and plaster of Paris with fibular osteotomy all have excellent results.

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