Unexpected tibial non-union after minimally invasive bridge plating: a case report

Abstract A fit 42-year-old woman presented to our department with a closed isolated distal tibial and fibular shaft fracture (AO 42-B1.3), which was addressed with a minimally invasive plate osteosynthesis (MIPO) with a bridging technique for both the tibia and the fibula. No risk factors for healin...

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Bibliographic Details
Published in:Injury 2015-12, Vol.46, p.S40-S43
Main Authors: Cheli, Andrea, Soldati, Francesco, Caruso, Gaetano, Lorusso, Vincenzo
Format: Article
Language:English
Subjects:
Accidental Falls
Adult
Bone Nails
Bone Plates
bridge plating
delayed union
Female
Fracture Fixation, Internal - methods
Fracture Healing
Fractures, Malunited - complications
Fractures, Malunited - diagnostic imaging
Fractures, Malunited - surgery
Humans
IM nail
MIPO
non-union
Orthopedics
Pain - diagnostic imaging
Pain - surgery
Postoperative Complications - diagnostic imaging
Postoperative Complications - etiology
Postoperative Complications - surgery
Reoperation
tibia shaft fractures
Tibial Fractures - complications
Tibial Fractures - diagnostic imaging
Tibial Fractures - surgery
Treatment Outcome
Weight-Bearing
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Summary:Abstract A fit 42-year-old woman presented to our department with a closed isolated distal tibial and fibular shaft fracture (AO 42-B1.3), which was addressed with a minimally invasive plate osteosynthesis (MIPO) with a bridging technique for both the tibia and the fibula. No risk factors for healing issues were known at the time of surgery. At the 6-month follow-up, the leg was still painful during walking and the fracture site was still evident on the radiographs. Bone and CT-scans confirmed the diagnosis of oligotrophic non-union. A revision surgery was then successfully performed with a reamed IM tibial nail and a fibular osteotomy taking into consideration both biological and mechanical factors. Surgeons must treat tibial shaft fractures avoiding unnecessary damage to soft tissue, restoring an appropriate reduction of the bony segment and providing an adequate fixation; however, other factors may play a role in the development of “unexpected non-union”.
ISSN:0020-1383
1879-0267
DOI:10.1016/S0020-1383(15)30044-9