Abstract
Objective
To investigate the outcomes of patients following the chipping procedures as an alternative to bone grafting in treatment of non-unions after long bone fracture.
Patients
Sixteen patients with femoral or tibial non-union were included. The median follow-up was 24 months.
Intervention
Non-unions were treated by the chipping procedure and re-install of an intramedullary nail or locked plate(s) without bone grafting.
Main Outcome Measurements
Radiographic bone union, walking ability, and complication were evaluated.
Results
Fourteen non-unions clinically and radiographically healed with a median time of 7.5 months. For these cases, patients were able to walk without walking aids within 9 months after surgery. Pre-existing deformities (e.g., varus and mal-external rotation) were anatomically corrected after the revision surgery for non-union. Radiographic consolidation could not been obtained for two cases within 12 months after chipping procedures; one nonunion after old osteomyelitis and another after supracondylar fracture. Lack of stability at chipping site may be one of the reasons for failure of the procedures. Post-operative temporal anemia and swelling of the thigh were common complications after surgery.
Conclusions
Chipping the non-union site was likely to enhance fracture healing, and this technique was useful as an alternative to bone grafting in treatment of femoral non-union, especially for both atrophic and hypertrophic non-unions with deformities.
