Treatment of Non-Union after Tibial Shaft Fracture with a Full Cortical Thickness Inlay Bone Graft

Abstract

Twenty-seven non-infected delayed union or non-union fractures of the shaft of the tibia in 26 patients were operated on with a full cortical thickness inlay graft taken from the injured leg. The initial trauma was moderate in 9 fractures and severe in 18. Fifteen fractures were closed injuries and 12 open. The fracture pattern was longitudinal in 5 cases, transverse in 11 and communited in 11. Surgery was performed 12 to 72 weeks (mean: 30 weeks) after the fractures had been sustained.

All fractures healed after the bone grafting procedure. The time until union was established after surgery ranged from 6 to 37 weeks (mean: 17 weeks). The healing time was neither influenced by the initial type of fracture pattern (p > 0.05) nor by the fracture age at surgery (r = −0.21). Of 13 patients re-examined 8 to 16 years after surgery, the clinical results were classified as excellent in 8, as fair in 2, and as poor in 3 patients.