Abstract

• Nonunion after tibia fracture is a relatively common problem. The cases of nonunion have been known open and comunited fracture, extensive soft tissue injury, interposition of the soft tissue, distarbance of the blood supply and inadequate fixation. A number of methods stimulating union have born described.
  These include fibular osteotomy followed by weight-bearing in a cast, autogenous boone graft with or without additional stabilization, internal or external fixation with compression, open or closed IM nailing and even electromagetic stimulation.
  In this paper we carried out retrospective study of the 24 nonunion of the tibia fracture which were treated at the Department of Orthopeadic Surgery, Kon-Kuk University Hospital from March 1990 to March 1995.
  The results were as follows:
  1. Among 24 cases of monunions, 16cases(66.6%) were communited fractures and 18cases(75%) were open fractures.
  2. Hypervascular nonunion were 12cases and avascular nonunion were 12cases. Previous methods of treatinent were conservative treatment in 6cases of closed fracture and were treated with Ender nailing, multiple K-wire fixation, Ilizarolr external fixation, monofixator external fixation in 1 Bcases of open fractures.
  3. The average duration from injury to dignosis of nonunion was 7 months tweets.(Range 5 months to 24months)
  4. Tibial nonunion were treated with plate and screw with bone graft(Bcases), Interlocking IM nail ing(14cases), and nizarov external fixation with bone graft(teases).
  5. The average time of union was 23weeks in all patients:
  24 weeks in the case of plate and screw with bone graft.
  20 weeks in the case of interlocking IM nailing.
  28 weeks in the case Ilizarov external fixation with bone graft.
  6. The main complications were joint stiffness due to long-term cast irnrnobiliBation in the case of plate and screw with bone graft, LROM of joint contracture and external pin site in the case of Ilizarov external fixation with bone graft, deep infection Icase and knee joint pain teases due to proximal nail protrusion in the case of Interlocking IM nailing.
• Key words: Tibia, Nonunion, Plate and Screws, Ilizarov external fixator, Interlocking IM nailing

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