Management of Infected Tibial Nonunions With Sequestration in the Dog

Osteomyelitis with sequestration of large fragments of cortical bone accompanied delayed union-nonunion in the tibia of three dogs. All fracture sites were grossly unstable at initial presentation, with the sequestration creating large bony deficits that required bone grafting. All three fractures were treated by the application of external fixation, seques-trectomy, debridement, cancellous bone grafting, and dependent wound drainage. One animal refractured the tibia causing an exacerbation of the osteomyelitis. Reapplication of an external fixation frame and direct current electrical stimulation resulted in bony union. There were no recurrences of infection on long-term follow-up in any of the three tibias.