Mechanical and biological treatment of long bone non-unions

Non-union (NU) of bones is a multifactorial phenomenon. Infected non-unions and/or those with bone loss require 'biological treatment', such as the excision of the pathological infected non-union site or the 'creation' of new bone substance by the use of distraction techniques. The treatment of choice that meets both the biological and mechanical requirements is that of the external fixation, in as much as it has an extremely low septic complication rate and the mechanical environment can be varied automatically or programmed depending on the requirements. The authors report on a total of 287 cases of non-union treated with external fixation, with a 93% success rate.