Twenty consecutive patients who had non-union of twenty-two fractures
(two of the patients had a segmental fracture) of the tibia underwent open
reduction, debridement, and intramedullary nailing that was supplemented by
bone-grafting with either autogenous cancellous iliac bone or cortical
reamings of bone from the intramedullary canal. Eighteen patients had
significant deformity associated with the tibial fracture. All but three
patients had postoperative splinting for two to four weeks, followed by
walking without a brace; the three patients who did not have postoperative
splinting were more than sixty-five years old. All of the fractures went on
to union. Two patients had a minor complication that did not affect the
final result. Incorporation of callus across the site of non-union occurred
at a rapid rate. Anatomical alignment of the tibial shaft was obtained in
nineteen of the twenty patients.