- 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;
Does Screw Configuration or Fibular Osteotomy Decrease Healing Time in Exchange Tibial Nailing?
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.
Factors influencing the outcome of closed tibial fractures treated with functional bracing.
Danger zones associated with fibular osteotomy.
Treatment of delayed union or non-union of the tibial shaft with partial fibulectomy and an Ilizarov frame.
The effects of the interosseous membrane and partial fibulectomy on loading of the tibia: a biomechanical study
Partial resection of fibula in treatment of ununited tibial shaft fractures
Exchange Nailing for Aseptic Tibial Shaft Nonunion: Emphasis on the Influence of A Concomitant Fibulotomy