A Study on Factors Influencing Nonunion Tibia with Failed Fixation and Its Management Outcome

摘要

Background: Nonunion tibia is not uncommon due to various deleterious factors. We came across a significant number of cases of nonunion owing to fallacy in primary treatment modalities. This study is to analyze and identify the preventable causes of nonunion and their outcomes after our treatment with refixation and bone grafting. Materials and methods: It is a retrospective study of 53 patients of failed fixation resulting in nonunion tibia treated in our center between June 2018 and May 2020. All patients were treated with internal fixation and bone grafting after implant removal. The surgery was done by a single surgeon for all patients with inclusion and exclusion criteria excluding open fractures. Results: All 53 cases of nonunion united at 3 months. As per the functional outcomes concerned using short form (SF-36) score, we found 52 cases had excellent outcomes and three had late infection necessitating implant removal. We could delineate certain preventable reasons for nonunion from this study, mostly due to treatment modalities. Conclusion: We conclude that certain technical factors play a major role in nonunion, which could be easily averted by paying meticulousattention to surgical techniques and details.