A patient is experiencing nonunion of a fractured tibia after eight weeks in a long leg cast. Which of the following interventions may be necessary at this time to encourage bone healing?

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Nonunion after eight weeks in a cast indicates that the fracture is not healing properly and may require more aggressive interventions like surgery to promote bone healing. Open reduction and internal fixation (ORIF) may be necessary to align the bone fragments and stabilize them with internal hardware. Removing the old cast and reapplying another or placing the patient in Buck's traction are not likely to be effective at this stage. Bone debridement may be necessary if there is infection or dead tissue interfering with bone healing, but it is not the first-line intervention for nonunion.

A Patient Is Experiencing Nonunion of a Fractured Tibia After