Nonunion of the tibia treated with Küntscher intramedullary nailing.

Nonunion of the tibia was treated by Küntscher intramedullary nailing un 48 patients. Thirty patients were treated with a completely closed intramedullary nailing and 18 required an open tibial osteotomy to realign the fracture. Bone grafting was not performed. The average time elapsed from injury to surgery was 15 months and the average healing time, as determined roentgenographically, was nine months following surgery. Three postoperative infections cleared with debridement and antibiotic therapy and subsequently united. There were two failures with persistent nonunion. Closed intramedullary nailing is an effective method of managing nonunion of the tibia in properly selected cases.