Nonunion

      Diagnosis

    1. Aseptic/ septic ( with active infection/ with e/o old infection or with no e/o infection)
    2. Mobile/ stiff
    3. Nonunion of right tibia (or ulna or femur or humerus or clavicle) shaft at M/3- L/3 junction
    4. In an operated case
    5. With 4 cm limb length discrepancy/ gap
    6. With 20 deg varus deformity
    7. With knee stiffness
    8. Of 1 year duration
    9. In a 40year old male labourer
    10. Presently disabled due to inability to weightbear

      11. History

    11. mechanism of injury,
    12. time,
    13. open/closed,
    14. treatment taken,
    15. time of treatment,
    16. compliance with treatment,
    17. Weightbearing
    18. Smoker/ alcoholic
    19. Diabetic

      20. Examination

    20. Abnormal painless/ painful mobility in anteroposterior & lateral directions
    21. Absence of transmitted rotations
    22. Bone ends are tickened, bone gap palapable, implant palpable
    23. No local tenderness at fracture site
    24. No e/o infection in the form of
      • local rise of temperature,
      • puckered adherent scar & sinuses,
      • irregular thickened bone

    26. 20 deg varus deformity ( fixed/ mobile)
    27. 4 cm shortening of leg
    28. 2 cm calf wasting
    29. Knee stiffness with 0 to 90 painless range, normal ankle range
    30. No lymphadenopathy
    31. No distal neurovascular deficit
    32. Gait & ambulation status in lower limb
    33. prehensile function in upeer limb
    34. Check for scars of bone grafting

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