Purpose Plating non-unions of the tibial diaphysis often
presents the technical problem of poor purchase of screws
due to osteoporosis. To improve the stabilization, insertion
of one or more screws through the plate across the tibiofibular
space to the fibula (fibula-pro-tibia plating) has been
practiced. The aim of this study is to evaluate the
effectiveness of the fibula-pro-tibia plating technique in
managing difficult diaphyseal tibial non-unions.
Methods Between 2000 and 2008, 30 patients with diaphyseal
non-union of tibia were managed with this technique.
The time between injury and index operation ranged
between six and 24 months (average, 11 months). Sixteen
patients had three surgical procedures before the index
operation, ten had two procedures and four patients had one.
Results The duration of follow-up ranged between ten and
38 months (average 26 months). The mean healing time
was 3.5 months. Complications were minimal and included
two cases of delayed union which required regrafting after
four months and two cases, which had infected nonunion,
had reactivation of the infection, which resolved completely
after achieving union and removing the plates. There was
no negative effect from this fixation technique on the ankle
joint motion.
Conclusion The fibula-pro-tibia plating technique is an
effective variation in plating diaphyseal tibial non-unions.