Aseptic nonunion of the tibia treated by plating and bone grafting: retrospective study about 40 cases

J Orthop Surg Res. 2022 Jun 21;17(1):321. doi: 10.1186/s13018-022-03216-z.

Abstract

Objective: The objective of this study was to evaluate the clinical and radiological results of the treatment of aseptic nonunion of the tibia by plating and bone grafting.

Material and methods: This retrospective study included 40 patients with aseptic nonunion of the tibia, treated in the Trauma-Orthopedic department B4 of CHU Hassan II in Fez-Morocco. The average age was 41 years (range 25-60 years). The initial fractures were in the middle third of the tibia for the majority of our patients. We used the ASAMI criteria to assess the results.

Results: We found 45 patients with aseptic nonunion of the tibia who were treated by the same surgical team and followed in postoperative consultation for a fixed period of 10 months. Three patients lost to follow-up and two patients refused the treatment. In 37 patients (92.5%), union was obtained after a mean delay of 4.3 months (range 3-7 months). The average time from initial treatment to treatment for nonunion was eight months (range 6-10 months). According to the ASAMI classification, bone results were excellent in 26, good in 8, fair in 3 and poor in 3; functional results were excellent in 10, good in 16, fair in 11 and poor in 3.

Conclusions: Our study suggests that the combination of screwed plate and autograft in the treatment of aseptic nonunion of the tibia has provided satisfactory results. A well-codified management of the initial fracture remains the gold key to prevent the occurrence of pseudarthrosis.

Keywords: Aseptic nonunion; Bone graft; Bone plate; Retrospective study; Tibia.

MeSH terms

  • Adult
  • Bone Plates*
  • Bone Transplantation* / methods
  • Fracture Fixation, Internal / methods
  • Fracture Healing
  • Fractures, Ununited / diagnostic imaging
  • Fractures, Ununited / surgery
  • Humans
  • Middle Aged
  • Retrospective Studies
  • Tibia / diagnostic imaging
  • Tibia / surgery
  • Tibial Fractures* / diagnostic imaging
  • Tibial Fractures* / surgery
  • Treatment Outcome