In situ grafting of excised fracture callus followed by Ilizarov external fixation for treatment of nonunion after open fracture of tibia.

摘要

It has been estimated that about 2.5% of long-bone fractures have developed into a nonunion.1 Particularly in cases of severe open fracture of the tibia (Gustilo types II and HI), more than 10% reportedly have resulted in nonunion.Development of nonunion is thought to be associated with multiple factors, such as mechanic and biologic environments. Unfavorable mechanic environments include instability at the fracture site, which allows excessive motion. Inadequate biologic environments include diminished blood supply, infection, and soft-tissue coverage. Radiographic findings proposed by Weber et al. reflect the conditions underlying the nonunion, leading to help the choice of treatment options.