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Nonunion of Tibial Fracture With Bone Defect

Otto E. Aufranc, MD; William N. Jones, MD; Roderick H. Turner, MD
JAMA. 1966;196(4):355-359. doi:10.1001/jama.1966.03100170097032.
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Dr. Turner: A 19-year-old college student was thrown through the rear door of an automobile following a two-car collision. He was admitted to a hospital in a neighboring state and was found to have the following multiple injuries: bilateral fractured pubic rami; bladder and urethral lacerations; bilateral closed femoral-shaft fractures; closed fracture-dislocation of the right ankle; closed fracture of the right medial tibial plateau; right peroneal nerve palsy; open fractures of the left tibia and fibula with gross contamination and loss of approximately five inches of the middle portion of the tibia. Blood supply and sensation were entirely normal in the left foot.

After initial management of shock by transfusion with seven units of whole blood, laparotomy was performed to repair the lacerated bladder. He was placed in bilateral balanced suspension with bilateral proximal tibial wires for traction. The left leg wound was debrided and packed open, but became grossly


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