Delayed union is a common complication in fractures of both bones of the leg, especially those in the lower third. The term will be here used to describe those cases in which there are movement between the fragments and tenderness at the site of fracture, and in which the roentgenograms reveal open medullary cavities and little or no callus formation. Pseudarthrosis has not developed in these cases.
The treatment for delayed union has very generally been direct fixation of the broken ends by metal inserts or bone grafts. These methods may succeed; but in too many instances they have failed because a long period of immobilization has produced atrophic and poorly nourished fragments—conditions unfavorable to the production of callus or the proliferation of a bone graft. The patient has also been subjected to all the risks of a major operation, including the danger of sepsis. The clinical picture of these