The Journal of Bone and Joint Surgery, Vol 63, Issue 2 226-231, Copyright © 1981 by Journal of Bone and Joint Surgery, Inc
Modified Nicoll-graft treatment of gap non-unions in the upper extremity
WR Shelton and FP Sage
Sixteen gap non-unions (seven in the radius, eight in the ulna, and one in
the humerus) in fifteen patients were treated with a full-thickness
corticocancellous iliac-crest graft, 1.2 to 2.5 centimeters in length, to
replace the bone loss, and with a compression plate to provide stability.
Thirteen of the fifteen fractures with adequate follow-up united and the
grafts were incorporated in an average of 13.5 weeks, an 87 per cent
success rate. The stability achieved by the compression plate allowed early
removal of the plaster cast and institution of active exercises. In the two
failures, the graft was not resorbed, and it filled the gap in the bone but
failed to unite at one end.