Küntscher intramedullary reaming and nail fixation for non-union of fracture of the femur and the tibia.

Rigid stability has long been the accepted major principle for treatment of non-union of shaft fractures (MUller, Allgower and Willenegger 1965; B#{246}hler1966; MUller 1966; KUntscher 1967). Until recently, methods of gaining stability have usually combined internal fixation by osteosyntheses and external fixation by plaster or traction (Boyd, Anderson and Johnston 1966). These methods have the disadvantage of further increasing the joint stiffness and muscle atrophy which usually accompany non-union. Moreover, the fixation does not allow weightbearing, an important stimulus to fracture union. It was therefore interesting that KUntscher (Fischer 1965, KUntscher 1967) was able to improve on his method of intramedullary nail fixation by reaming the shaft to uniform diameter, thus ensuring such rigid fracture fixation that immediatejoint movement and weight-bearing could be allowed even in cases of non-union (Maurath and Christ 1963). This paper reports a consecutive series of thirty-five cases of non-union of femur or tibia, treated by the modern K#{252}ntscher method. Before operation some of these limbs were subjected to transfixation distraction for correction of shortening or mal-alignment (K#{252}ntscher 1967, Christensen 1970).