Simple plan of treatment for aseptic non-union of Diaphyseal Fractures of long bones
AbstractBackground; The treatment of nonunion of long bones using internal fixation with compression plate is not a common practice but review of literature does not condemn it. Closed intramedullary nailing is frequently recommended, but at times it is not feasible. In this study, the role of internal fixation with compression plate for the treatment of long bones nonunion has been evaluated. Method: All the patients in this study were treated by freshening the fracture ends, opening the medullary cavities, fixing the fractures with DCP and packing autogenous cancellous bone graft aroud the nonunion site. There were 20 patients with average age of 36 years. There were 17 males and three females. There were nine femoral, eight tibial and three humeral non-unions. The initial treatment was operative in eight, with external fixation in four, by plaster in four and by bonesetters in four. Infected cases were not included in this study. Average follow up was 18.8 months. Results: All nonunions healed on an average at 19 weeks. There was no incidence of infection except stitch abscess in two cases, which healed after removal of stitches. There was no donor graft area morbidity. In one case a repeat bone graft was needed for delayed union. In one case of humeral non union radial nerve palsy occurred which recovered at 10 weeks. Conclusion; For managing nonunion of long bones, compression plate fixation with cancellous bone grafting is useful where closed intramedullary nailing is not technically or economically feasible.
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