Treatment of non-united tibial fractures by Kuntscher nailing

ABSTRACT

Non-union of the tibial shaft was treated by Kuntscher intramedullary nailing in 32 patients. Ten patients were treated with closed intramedullary nailing and twenty-two required open nailing to realign the fracture or to remove a failed implant. Bone grafting was undertaken in sixteen patients and sixteen patients also had fibular osteotomy. The average time from injury to surgery was 11 months, and the average healing time, as determined radiologically, was 6 months following surgery. One patient had a postoperative infection which cleared with debridement, drainage and antibiotic therapy and subsequently united. All the fractures went on to union. Most of our patients had the full range of knee, ankle and foot movement. Intramedullary nailing is an effective method of managing non-union of the tibial shaft fracture