Nonunion of long bones presents a formidable prospect to the patients. It is serious complication prolonging patient morbidity, time lost from work and economic handicap. Several different treatment methods have been advocated for management of
this
difficult problem including rigid fixation, bone graft and electrical stimulation but definitive treatment too is not clear.
In the treatment of nonunion, we must be remembered principal predisposing factors related to the injury, problems incident to treatment and chief factor prompting union.
To solve these problems we used some principles. Those are rigid fixation and bone graft in noninfected cases, and meticulous debridement of infected tissue, management of soft tissue and bony defect in infected cases.
@ES From Jan. 1980 to Dec. 1993 we treated 48 ununited fractures of long bones in lower extremity and the result was as follows.
@EN 1. The nonunion union consisted of 32 for tibia, 32 for femur.
2. There were 25 closed fractures and 23 open fractures.
3. The comminuted fracture was most common in the shape of fracture.
4. In infected cases, staphylococcus aureus was the most common organism.
5. Of the probable cause of nonunion, infection was the most common cause.
6. There were 30 hypertrophic nonunion and 18 atrophic nonunion.
7. The average leg length discrepancies were 2.1 cm shortening in femur and 1.5cm in tibia.
8. The average times required for bony union were 7.1 months in femur and 6.3 months in tibia of the noninfected cases, 9.1 months in femur 8.2 months in tibia of the infected cases.
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