Non union long bones treated with rigid fixation and autogenous bone grafting. A Series of 50 Cases

Introduction:The surgical treatment of aseptic nonunion often represents a more challenging situation for the orthopaedic surgeon than treatment of the primary fracture.In fact, it may be necessary not only to -rivitalize‖ the nonunion area, but also to exchange the bone fixationdevices and to place some refill material in the bone gap.Objective: To study the Non-union long bones treated with rigid fixation and autogenous bone grafting. Materials and methods:We present the results of 50 cases of long bone nonunion that have been treated in a period of 3 years (2011)(2012)(2013) by open approach to the nonunion site with autologous bone graft interposition.The site 11humerus, 9 forearms, 12 femurs, 18 tibias and the type of nonunion (42 atrophic, 8 hypertrophic) was considered in the surgical planning as were the mechanic and biological problems.Newosteosynthesis was performed in50 cases: with plate and screws in 29 cases, with intramedullary nails in 16 cases, with external fixators in 2 cases and with only bone grafting in 3 cases.Bone graft, always autologous from the iliac crest was used in 48 cases and fibula with iliac graft was used in 2 cases.Result: Healing of the nonunion was successful in 49cases in a mean time of 9.8 weeks with few complications which was easily manageable and did not hinder the functional result.Conclusion: Autogenous Cortico-Cancellous Bone graft & Rigid Fixation still Gold Standard Treatment for Non-Unions in the era of Vascularised Bone Grafts.