Distal Tibial Periarticular Nonunions

• DOI: 10.1097/bot.0000000000000011
• Publication Date: 2013-09-27T22:50:13Z
• Authors: Patrick C. Schottel; Saravanaraja Muth...; S. Robert Rozbruch
• Keywords: Tibial Fractures; 03 medical and health sciences; 0302 clinical medicine; External Fixators; Intra-Articular Fractures; Fracture Fixation; Fractures, Ununited; Osteogenesis, Distraction; Humans; Female; Middle Aged; Limb Salvage; 3. Good health

A nonunion of the distal tibial metaphysis in close proximity to the articular surface is a challenging clinical problem. Many of the commonly used techniques in a surgeon's treatment armamentarium can be ineffective because of the relative lack of distal bone stock. This study describes a technique of en bloc excision of all infected or nonunited distal tibial bone with an application of a circular external fixator and limb shortening. After treatment with parental antibiotics, when appropriate, and docking of the distal excision site, distraction osteogenesis of the proximal tibia is performed with a second circular frame.