Nonunion of the Shafts of Long Bones

Abstract

Prompt surgical cleansing of open fracture wounds is imperative; every hour counts. Open reduction of closed fractures predisposes to nonunion and should be avoided whenever possible. When nonunion occurs, union can be obtained by bone grafting in more than 90 per cent of cases. No single method of grafting is the “best;” the surgeon must select the procedure best suited to a given situation. The operation should accomplish contact, fixation, osteogenesis and, if possible, compression. Autogenous grafts are preferable to homografts.