{"id":"https://openalex.org/W7162008232","doi":"https://doi.org/10.36347/sasjs.2026.v12i05.019","title":"Aseptic Tibial Nonunion Following Open Fracture Initially Managed with External Fixation: A Case Series of Three Patients","display_name":"Aseptic Tibial Nonunion Following Open Fracture Initially Managed with External Fixation: A Case Series of Three Patients","publication_year":2026,"publication_date":"2026-05-20","ids":{"openalex":"https://openalex.org/W7162008232","doi":"https://doi.org/10.36347/sasjs.2026.v12i05.019"},"language":"en","primary_location":{"id":"doi:10.36347/sasjs.2026.v12i05.019","doi":"https://doi.org/10.36347/sasjs.2026.v12i05.019","is_oa":true,"landing_page_url":"https://doi.org/10.36347/sasjs.2026.v12i05.019","pdf_url":null,"source":{"id":"https://openalex.org/S4210226933","display_name":"SAS Journal of Surgery","issn_l":"2454-5104","issn":["2454-5104"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"SAS Journal of Surgery","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"diamond","oa_url":"https://doi.org/10.36347/sasjs.2026.v12i05.019","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5136718787","display_name":"Abdelrahman Akkoumi","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Abdelrahman Akkoumi","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5136695252","display_name":"Reda Bahij","orcid":"https://orcid.org/0009-0004-2683-6938","observed_orcids":["https://orcid.org/0009-0004-2683-6938"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"R. Bahij","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5135961902","display_name":"O. Aguenaou","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"O. Aguenaou","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5135968111","display_name":"MR. Fekhaoui","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"MR. Fekhaoui","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5135910671","display_name":"J. Mekaoui","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"J. Mekaoui","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5021089385","display_name":"M. Boufettal","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"M. Boufettal","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5057432348","display_name":"RA. Bassir","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"RA. Bassir","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5000667065","display_name":"M. Kharmaz","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"M. Kharmaz","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"last","author":{"id":"https://openalex.org/A5135960603","display_name":"Molay O. Lamrani","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Molay O. Lamrani","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":0,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.3027407,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"12","issue":"05","first_page":"435","last_page":"441"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10658","display_name":"Bone fractures and treatments","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2732","display_name":"Orthopedics and Sports Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10658","display_name":"Bone fractures and treatments","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2732","display_name":"Orthopedics and Sports Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11509","display_name":"Hip and Femur Fractures","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10776","display_name":"Spinal Fractures and Fixation Techniques","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/open-tibial-fractures","display_name":"open tibial fractures","score":0.9369999766349792},{"id":"https://openalex.org/keywords/external-fixation","display_name":"external fixation","score":0.9200000166893005},{"id":"https://openalex.org/keywords/reamed-intramedullary-nailing","display_name":"reamed intramedullary nailing","score":0.9190000295639038},{"id":"https://openalex.org/keywords/fracture-healing","display_name":"fracture healing","score":0.4410000145435333},{"id":"https://openalex.org/keywords/iliac-crest-bone-graft","display_name":"iliac crest bone graft","score":0.6800000071525574}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9190000295639038},{"id":"https://openalex.org/C92162645","wikidata":"https://www.wikidata.org/wiki/Q655955","display_name":"Intramedullary rod","level":2,"score":0.9088000059127808},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.7803999781608582},{"id":"https://openalex.org/C2779330695","wikidata":"https://www.wikidata.org/wiki/Q7049641","display_name":"Nonunion","level":2,"score":0.753000020980835},{"id":"https://openalex.org/C2776813713","wikidata":"https://www.wikidata.org/wiki/Q920565","display_name":"External fixation","level":3,"score":0.5996000170707703},{"id":"https://openalex.org/C2776337968","wikidata":"https://www.wikidata.org/wiki/Q3814234","display_name":"Bone grafting","level":2,"score":0.5580999851226807},{"id":"https://openalex.org/C181268634","wikidata":"https://www.wikidata.org/wiki/Q4071230","display_name":"Aseptic processing","level":2,"score":0.5454999804496765},{"id":"https://openalex.org/C195121873","wikidata":"https://www.wikidata.org/wiki/Q1131385","display_name":"Medullary cavity","level":2,"score":0.4526999890804291},{"id":"https://openalex.org/C146249460","wikidata":"https://www.wikidata.org/wiki/Q2914991","display_name":"Fixation (population genetics)","level":3,"score":0.4244999885559082},{"id":"https://openalex.org/C2776350087","wikidata":"https://www.wikidata.org/wiki/Q265868","display_name":"Cancellous bone","level":2,"score":0.39629998803138733},{"id":"https://openalex.org/C2992115439","wikidata":"https://www.wikidata.org/wiki/Q6027402","display_name":"Tibial fracture","level":3,"score":0.3797999918460846},{"id":"https://openalex.org/C2777236700","wikidata":"https://www.wikidata.org/wiki/Q178366","display_name":"Tibia","level":2,"score":0.3781000077724457},{"id":"https://openalex.org/C8337478","wikidata":"https://www.wikidata.org/wiki/Q1777289","display_name":"Bone healing","level":2,"score":0.36390000581741333},{"id":"https://openalex.org/C2780707029","wikidata":"https://www.wikidata.org/wiki/Q1512017","display_name":"Long bone","level":2,"score":0.3384999930858612},{"id":"https://openalex.org/C190892606","wikidata":"https://www.wikidata.org/wiki/Q3512464","display_name":"Radiological weapon","level":2,"score":0.33399999141693115},{"id":"https://openalex.org/C68312169","wikidata":"https://www.wikidata.org/wiki/Q216685","display_name":"Orthopedic surgery","level":2,"score":0.32850000262260437},{"id":"https://openalex.org/C2779785605","wikidata":"https://www.wikidata.org/wiki/Q7049641","display_name":"Pseudarthrosis","level":2,"score":0.3253999948501587},{"id":"https://openalex.org/C2776206872","wikidata":"https://www.wikidata.org/wiki/Q162595","display_name":"Humerus","level":2,"score":0.3003000020980835},{"id":"https://openalex.org/C3018917446","wikidata":"https://www.wikidata.org/wiki/Q7049641","display_name":"Delayed union","level":3,"score":0.28859999775886536},{"id":"https://openalex.org/C2780193326","wikidata":"https://www.wikidata.org/wiki/Q16343","display_name":"Clavicle","level":2,"score":0.2653999924659729},{"id":"https://openalex.org/C3018021831","wikidata":"https://www.wikidata.org/wiki/Q7049641","display_name":"Non union","level":2,"score":0.2524999976158142}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.36347/sasjs.2026.v12i05.019","doi":"https://doi.org/10.36347/sasjs.2026.v12i05.019","is_oa":true,"landing_page_url":"https://doi.org/10.36347/sasjs.2026.v12i05.019","pdf_url":null,"source":{"id":"https://openalex.org/S4210226933","display_name":"SAS Journal of Surgery","issn_l":"2454-5104","issn":["2454-5104"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"SAS Journal of Surgery","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.36347/sasjs.2026.v12i05.019","doi":"https://doi.org/10.36347/sasjs.2026.v12i05.019","is_oa":true,"landing_page_url":"https://doi.org/10.36347/sasjs.2026.v12i05.019","pdf_url":null,"source":{"id":"https://openalex.org/S4210226933","display_name":"SAS Journal of Surgery","issn_l":"2454-5104","issn":["2454-5104"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"SAS Journal of Surgery","raw_type":"journal-article"},"sustainable_development_goals":[{"score":0.98580002784729,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Case Report","id":"https://openalex.org/study-designs/case-report"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W2750028984","https://openalex.org/W2086341862","https://openalex.org/W2051299371","https://openalex.org/W1942570371","https://openalex.org/W2417369642","https://openalex.org/W3086529446","https://openalex.org/W2537080690","https://openalex.org/W3198063636","https://openalex.org/W7015140533","https://openalex.org/W2365742009"],"abstract_inverted_index":{"Background:":[0],"Open":[1],"tibial":[2,57,64,148,165],"fractures":[3,65],"are":[4,132],"associated":[5],"with":[6,54,68,95,120,134,142,179],"a":[7,27,49],"high":[8],"risk":[9],"of":[10,51,60,140,157],"nonunion,":[11,58],"particularly":[12],"when":[13],"prolonged":[14,171],"external":[15,69,172],"fixation":[16],"is":[17],"employed":[18],"as":[19],"the":[20,34,109,155,184],"primary":[21],"stabilization":[22],"method.":[23],"The":[24,130],"pathophysiology":[25],"involves":[26],"combined":[28,158,178],"mechanical":[29],"and":[30,42,103,160,170],"biological":[31,96,161],"failure":[32],"at":[33],"fracture":[35,169],"site,":[36],"including":[37],"cortical":[38,99],"devascularization,":[39],"axial":[40],"instability,":[41],"impaired":[43],"osteogenic":[44],"stimulation.":[45],"Methods:":[46],"We":[47],"present":[48],"series":[50,153],"three":[52,86,114],"patients":[53,115],"aseptic":[55,147,164],"diaphyseal":[56],"all":[59],"whom":[61],"sustained":[62],"open":[63,168],"initially":[66],"managed":[67],"fixation.":[70,173],"Time":[71],"from":[72,80,108],"initial":[73],"injury":[74],"to":[75,82],"definitive":[76],"surgical":[77,88],"treatment":[78,89,162],"ranged":[79],"8":[81],"12":[83],"months.":[84],"All":[85,113],"underwent":[87],"combining":[90],"reamed,":[91],"locked":[92],"intramedullary":[93,144,176],"nailing":[94,145,177],"stimulation":[97],"through":[98],"decortication,":[100],"medullary":[101],"preparation,":[102],"autologous":[104,180],"cancellous":[105],"bone":[106,181],"grafting":[107,182],"iliac":[110],"crest.":[111],"Results:":[112],"achieved":[116],"complete":[117],"radiological":[118],"consolidation":[119],"satisfactory":[121],"functional":[122],"recovery.":[123],"No":[124],"postoperative":[125],"infectious":[126],"complications":[127],"were":[128],"recorded.":[129],"outcomes":[131],"consistent":[133],"published":[135],"literature":[136],"reporting":[137],"union":[138],"rates":[139],"76\u201396%":[141],"reamed":[143],"for":[146],"nonunion.":[149],"Conclusion:":[150],"This":[151],"case":[152],"reinforces":[154],"efficacy":[156],"biomechanical":[159],"in":[163,187],"nonunion":[166],"following":[167],"Reamed,":[174],"interlocked":[175],"represents":[183],"gold-standard":[185],"approach":[186],"this":[188],"setting.":[189]},"counts_by_year":[],"updated_date":"2026-10-28T10:33:24.094632","created_date":"2026-05-22T00:00:00"}