Journal of Clinical Orthopaedics | Vol 7 | Issue 2 | Jul-Dec 2022 | page: 81-84 | Rohit Mahesh Sane, Kedar Anil Parelkar, Sunil Hiriyanna Shetty
Author: Rohit Mahesh Sane , Kedar Anil Parelkar , Sunil Hiriyanna Shetty 
 Department of Orthopaedics, D.Y. Patil University School of Medicine, Navi Mumbai – 400706, India.
Address of Correspondence
Dr. Rohit Mahesh Sane,
Department of Orthopaedics, D.Y. Patil University School of Medicine, Navi Mumbai – 400706, India.
Background: The most feared complication of fracture management is non-union. Non-union can be of the following types, hypertrophic, oligotrophic, atrophic, and septic. In view of a non-union, exchange nailing is preferred and so routinely performed for non-unions and fractures of the tibia.
Case Presentation: Here, we present a case of an implant failure from an atraumatic event in a case of atrophic non-union of the tibia, which was treated by exchange nailing and bone grafting. A 22-year-old male, with a history of the left closed tibia fibula diaphysis fracture 1 year ago, underwent exchange nailing with bone grating after having an atrophic non-union with implant breakage.
Conclusion: Implant failure and non-union are caused due to a wide variety of factors. Appropriate implant selection for fracture type, reaming, fracture site compression, good reduction, and adequate and early mobilization are important factors for a satisfactory union and prevention of secondary surgeries.
Keywords: Atrophic non-union, exchange nailing, implant breakage, non-traumatic event, tibia
- Bhan K, Tyagi A, Kainth T, Gupta A, Umar M. Reamed exchange nailing in nonunion of tibial shaft fractures: A review of the current evidence. Cureus 2020;12:e9267.
- Thomas JD, Kehoe JL. Bone Nonunion. Treasure Island, FL: StatPearls; 2020.
- Hierholzer C, Friederichs J, Glowalla C, Woltmann A, Bühren V, von Rüden C. Reamed intramedullary exchange nailing in the operative treatment of aseptic tibial shaft nonunion. Int Orthop 2017;41:1647-53.
- Högel F, Gerber C, Bühren V, Augat P. Reamed intramedullary nailing of diaphyseal tibial fractures: Comparison of compression and non-compression nailing. Eur J Trauma Emerg Surg 2013;39:73-7.
- Tall M. Treatment of aseptic tibial shaft non-union without bone defect. Orthop Traumatol Surg Res 2018;104:S63-9.
- Gómez-Barrena E, Rosset P, Lozano D, Stanovici J, Ermthaller C, Gerbhard F. Bone fracture healing: Cell therapy in delayed unions and nonunions. Bone 2015;70:93-101.
- Tosounidis TH, Calori GM, Giannoudis PV. The use of Reamer-irrigator-aspirator in the management of long bone osteomyelitis: An update. Eur J Trauma Emerg Surg 2016;42:417-23.
- Litrenta J, Tornetta P, Vallier H, Firoozabadi R, Leighton R, Egol K, et al. Dynamizations and exchanges: Success rates and indications. J Orthop Trauma 2015;29:569-73.
|How to Cite this article: Sane RM, Parelkar KA, Shetty SH. Exchange Nailing, for Atrophic Non-union of the Tibia, after Implant Breakage, Post a Non-traumatic Event. Journal of Clinical Orthopaedics Jul-Dec 2022;7(2):81-84.|