Algorithm 7- Tibial Non Union management


How do you treat a tibial non union ?
Rule out infection – infected tibial non uion treated as before like any other infected non union in a long bone .
Electrical Stimulation – 78 % success rate . ?

Hypertrophic Non union
Rigid internal fixation – compression plate, IM Rod or Ext. Fixator –
 98 % Success rate
Bone graft may not be necessary.

Atrophic Non union
Rigid internal fixation – Plate or IM ROD .
And Bone grafting.

Tibial Bone grafting – Posterolaterally , Anterior Central  or Pecutaneous Bone marrow injection

Fibulectomy may require in many non union .


Internal Fixation
Plate / rod  - Dynamically locked
Corrects deformity
Plate applied on convex side ( tension side )
Interfragmentary lag screw technique with plate.
Not used with infections .


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