Central grafting for persistent nonunion of the tibia. A lateral approach

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to the tibia, creating a central compartment. Rijnberg WJ. van Linge B. Journal of Bone & Joint Surgery - British Volume. 75(6):926-31, 1993 Nov. We report the operative technique and results of a new method of central grafting for persistent nonunion of the tibial shaft. The operation is performed through a lateral approach, anterior to the fibula. Fresh autogenous bone from the iliac crest is used to form a central bridge between the tibia and fibula above, below and at the level of the nonunion. In 48 tibiae, most with long-standing nonunion and some with infection or bone defects, sound healing was obtained in 45 after one operation. Only one failure needed amputation.