*Background: Post-traumatic tibial non-union in association with infection is a real surgical problem. When tibial shortening occurs and soft tissue (especially skin) complications are added to this problem due to multiple surgical procedures to solve the first problem, this is one of the heaviest complications in bone-joint surgery.
*Patients and methods: Twenty five tibial non-united fractures;(8-65y),complicated with infection ,shortening (4-9 cm.) and skin or other soft tissue complications; following repeated surgeries(2-5 previous operations) were subjected to debridement of the soft tissues at the non-union site with excision of bone ends till healthy bone (adding more shortening). Mono-planer external fixators were applied to all cases; compression was applied to fracture site, and distraction-callotasis principle was performed at a proximal (or distal) corticotomy.
*Results: Bone healing was achieved in 24 cases (96%) in 12 – 28 weeks (mean of 18.2 weeks). Infection was eradicated in 22 cases (88 %); all were united. The mean length gained was 7.7 cm (6to12.5 cm). Satisfactory results were obtained in 22 patients (88%) and unsatisfactory results in 3 patients(12 %).No major complications were encountered; There have been no refractures or loss of length. after a follow-up of 2.3 years (range 2 - 4 y).
*Conclusion: mono-planer devices when applied properly and combined with proper debridement can give a high success rate in achieving bone healing , eradication of infection and correction of shortening in tibial non-union associated with infection and shortening..
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