{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T23:23:32Z","timestamp":1782602612772,"version":"3.54.5"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,6]]},"abstract":"\n Objective:<\/jats:title>\n To evaluate the healing rate of aseptic nonunions of the distal third of the tibia treated with Ilizarov slow gradual compression and deformity correction.<\/jats:p>\n <\/jats:sec>\n \n Design:<\/jats:title>\n Retrospective cohort study.<\/jats:p>\n <\/jats:sec>\n \n Setting:<\/jats:title>\n Tertiary referral center.<\/jats:p>\n <\/jats:sec>\n \n Patients\/Participants:<\/jats:title>\n Ninety-four consecutive adult patients with 94 distal third tibial aseptic nonunions.<\/jats:p>\n <\/jats:sec>\n \n Intervention:<\/jats:title>\n Ilizarov external fixation and slow gradual compression; most patients also underwent bone grafting, deformity correction, or both before the initiation of compression.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measurements:<\/jats:title>\n Rate of bony union.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n Eighty-seven of 94 cases (92.6%) healed after slow gradual compression across the nonunion site with a circular external fixator. Four of the 7 patients who failed treatment healed after additional operative treatment, and the remaining 3 refused further care.<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Circular external fixation with slow gradual compression was successful in treating aseptic nonunions of the distal third of the tibia in 92.6% of cases. Careful selection of patients for this treatment method can lead to a high success rate with a relatively low rate of major complications.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence:<\/jats:title>\n Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/bot.0000000000001141","type":"journal-article","created":{"date-parts":[[2018,2,2]],"date-time":"2018-02-02T16:42:42Z","timestamp":1517589762000},"page":"301-305","source":"Crossref","is-referenced-by-count":7,"title":["High Rate of Union for Aseptic Distal Tibial Nonunions in Adults Treated With Slow Gradual Compression via Circular External Fixation"],"prefix":"10.1097","volume":"32","author":[{"given":"Bryce A.","family":"Cunningham","sequence":"first","affiliation":[{"name":"Department of Orthopedic Trauma, University of Texas Health Science Center, Houston, TX;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel P.","family":"O'Connor","sequence":"additional","affiliation":[{"name":"Department of Health and Human Performance, University of Houston, Houston, TX; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark R.","family":"Brinker","sequence":"additional","affiliation":[{"name":"Center for Problem Fractures and Limb Restoration, Fondren Orthopedic Group, Texas Orthopedic Hospital, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20230828","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.fcl.2007.11.004","article-title":"Salvage of pilon fracture nonunion and infection with circular tensioned wire fixation","volume":"13","author":"Hutson","year":"2008","journal-title":"Foot Ankle Clin N Am."},{"key":"R2-20230828","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1097\/BOT.0b013e318213f709","article-title":"Randomized, prospective comparison of plate versus intramedullary nail fixation for distal tibia shaft fractures","volume":"25","author":"Vallier","year":"2011","journal-title":"J Orthop 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