[ORT-L] Tibial Nonunion - Orthopedics Forum


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[ORT-L] Tibial Nonunion

jjbrooksmd at gmail
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Sep 21, 2007, 9:46 AM

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[ORT-L] Tibial Nonunion	Can't Post

A question for the group:

I have a 60 year old female with a tibial nonunion. It was an open
grade II midshaft short oblique Fx (sorry, no XR pics right now),
Rx-ed with immediate I&D and a minimally-reamed static 9mm nail. Soft
tissues healed well.

Fibula healed, tibia now with hypertrophic nonunion.
Anatomically-aligned. Not infected, ESR CRP normal, although patient
is recently diagnosed type II diabetic. She's a NON-smoker. Otherwise
healthy.

I'm planning a reamed exchange nailing, hopefully up to a 12mm nail,
and statically locking it. Also plan on medullary implantation of OP1
while passing the new nail.

QUESTION: Do I need to do a fibular osteotomy or is the reamed locked
exch-nail enough? Would anyone use OP1 also or is it overkill?

Thoughts appreciated!

Jeff

--
Jeffrey J. Brooks, MD
Orthopaedic Surgery & Sports Medicine Center
1290 Summer Street, #4400
Stamford, CT 06905
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