bstract:
Background:Non-united extra-articularproximaltibial
fractures may be due to distraction, soft tissue
interposition, poor vascular supply, or excessive
malalignment.Theaim ofthisstudywastoevaluatethe
doublefixationandiliacbonegraftfortreatmentofsuch
condition.
Methods:Thisstudyincluded15adultpatientswiththe
meanage37.9±5.2yearswithnon-unitedextra-articular
proximaltibialfracturesthatwereinitiallyfixedbysingle
implant(plateornail).60%ofcaseswereopenfracture
and80%ofcaseshadacomminutedfracture.Incases
withoutimplantfailure(3caseswithIMN,3caseswith
singlelateralplate),anadditionalmedialplatewasadded
asasupplementaryfixation.Incaseswithimplantfailure
(9caseswithsinglelateralplate);removalofthefailed
implant,fixationwithlaterallockedplateandanadditional
medialplateweredone.Inallcases,iliaccancellousbone
graftwasdone.Themeanfollowupperiodwas27±4.3
months.
Results:Therewere73.3% excellentand 26.7% good
outcomeaccordingtoJohnerandWruhs’criteria,with
meankneeROM was123°.Allfracturesunitedsolidly
afterameanperiodof21±2.7weeks.Themeantimeto
full,unprotectedweightbearingwas18±2.9weeks.Two
cases had a superficialinfection,and one case had
discomfortoverthemedialplate.
Conclusion:Doublefixationconstructandiliacbonegraft
hadasatisfactoryradiologicalandfunctionaloutcomefor
treatmentofnon-united extra-articularproximaltibial
fractures. |
