High success rate for augmentation compression plating leaving the nail in situ for aseptic diaphyseal tibial nonunions.

Abstract

To evaluate adjunctive compression plating leaving the previously unreamed inserted intramedullary nail (URIMN) in situ for treating a resultant diaphyseal tibial nonunion. Retrospective study. Level 1 trauma center (University Hospital). Patients treated by URIMN for diaphyseal tibial fractures that developed an aseptic hypertrophic nonunion. Dynamization of the nail and compression plating leaving the URIMN in situ. Radiographic and clinical parameters. The mean follow-up was 3.8 years (range 2-7 years). Mean time for healing was 15 weeks with a mean operation time of 63 minutes. Union occurred in 27/28 (96.4%). There were no infections. This simple technique seems to have a high success rate and should be considered when a nonunion occurs after URIMN. The need for an additional incision and removal of symptomatic implants remains a disadvantage. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.