Nonunion of a fractured tibia is seen in a patient after 8 weeks in a long leg cast. Which intervention may be necessary to encourage bone healing?
1. removing the old cast and reapplying another
2. placing the patient in Buck's traction
3. surgical intervention with open reduction and internal fixation
4. bone debridement
Correct Answer: 3
With nonunion, the patient will have persistent pain and movement at the fracture site. The site will need to be realigned and held in place with plates and screws to maintain the alignment. Buck's traction is not indicated. Removing the cast and applying a new one would not help a patient with a nonunion fracture. There is no evidence that the bone needs to be debrided.
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