Operative Treatment of Non-United Fractures of Long Bones

Several operative methods are in use for the treatment of established non-union of diaphyseal fractures of the long bones.The incidence of successful results, as well as the duration of post-operative immobilization, until safe healing occurs, vary considerably in the different reports, this depending mainly on the operative method used by each author.Autogenous or homogenous bone transplants are commonly used as inlay, anlay or sliding grafts, with or without resection of the sclerotic bone ends and with or without internal fixation.Thick compact bone transplants are usually preferred by several surgeons, as securing good stabilizing as well as biological properties for the healing of the non-union.An operative method for treatment of non-united fractures of the long bones is described in the present communication.The method is based on the following principles : a ) the fibrous and the sclerotic bone tissue at the site of the nonunion are resected only partially, b) the bone fragments are not dislocated and the fibrous connections around the non-union, stabilizing the bone ends are preserved, as advocated by Phemister (1947), c) the obliterated medullary cavity is carefully opened and its continuity restored, d ) a block graft of cancellous iliac bone together with additional bone-chips are used as transplantation material and e ) internal fixation is used only in cases with pronounced instability of the bone fragments.A series of non-united of diaphyseal fractures have been treated by this method and the obtained results are reported herewith.'I'AHLE 1 l'hc Muterid.