- Discussion:
- displaced tibia frx assoc w/ intact fibula are difficult to maintain in plaster;
- varus malunion of tibia is common and difficult to overcome;
- delayed union and
tibial non unions are also common when tibial frx occurs with an intact fibula;
-
hypertrophic nonunions (w/ intact fibula)
- initially are best treated w/ partial fibulectomy (1 cm) & full wt-bearing in a plaster
cast;
- success rate of greater than 75%;
- note, however, that partial fibulectomy may interfere with future plans for
posterolateral bone grafting;
- if fibulectomy fails to incite tibial healing, consider fixation w/ plate, IM nail, or an
external fixator;
Problems associated with tibial fractures with intact fibulae.
Plating of the fibula. Its potential value as an adjunct to external fixation of the tibia.
Partial fibulectomy for ununited fractures of the tibia. JC DeLee et al.
JBJS Vol 63-A. p 1390. 1981.
Factors influencing the outcome of closed tibial fractures treated with functional bracing.
Danger zones associated with fibular osteotomy.
