Tibial Shaft Nonunion: Exchange Nailing

  • Peter V. Giannoudis
  • Theodoros I. Tosounidis


Tibial diaphyseal symptomatic aseptic nonunions.

Tibial diaphyseal asymptomatic aseptic nonunions (after consultation with the patient).

Tibial diaphyseal septic nonunions (temporary antibiotic-impregnated polymethylmethecrylate followed by permanent nail) (two-stage operation).


Patellar Tendon Guide Wire Image Intensifier Screw Hole Nonunion Site 
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Further Reading

  1. Court-Brown CM, Keating JF, Christie J, McQueen MM. Exchange intramedullary nailing. Its use in aseptic tibial nonunion. J Bone Joint Surg Br. 1995;77(3):407–11.PubMedGoogle Scholar
  2. Zelle BA, Gruen GS, Klatt B, Haemmerle MJ, Rosenblum WJ, Prayson MJ. Exchange reamed nailing for aseptic nonunion of the tibia. J Trauma. 2004;57(5):1053–9.PubMedCrossRefGoogle Scholar
  3. Wiss DA, Stetson WB. Tibial nonunion: treatment alternatives. J Am Acad Orthop Surg. 1996;4(5):249–57.PubMedGoogle Scholar
  4. Richmond J, Colleran K, Borens O, Kloen P, Helfet DL. Nonunions of the distal tibia treated by reamed intramedullary nailing. J Orthop Trauma. 2004;18(9):603–10.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 2011

Authors and Affiliations

  • Peter V. Giannoudis
    • 1
  • Theodoros I. Tosounidis
    • 2
  1. 1.Academic Department of Trauma and Orthopaedic Surgery, School of MedicineUniversity of LeedsLeedsUK
  2. 2.Department of Trauma and Orthopaedic SurgeryLeeds Teaching Hospitals NHS TrustLeedsUK

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