Partial fibulectomy for ununited fractures of the tibia

Despite the improved rate of union reported with early weight-bearing in tibial shaft fractures, there continues to be a small number of patients with delayed union and non-union who present a dilemma to the surgeon. Partial fibular ostectomy (fibulectomy) is one means of promoting union in ununited fractures of the tibia. Fifty-one patients at our hospital underwent that treatment between December 1, 1971 and June 30, 1979, at twenty to fifty-nine weeks after the date of injury. Following the partial fibulectomy, 77 per cent of the tibial fractures healed. Failure of union after fibulectomy was associated with either failure of the patient to bear weight postoperatively, the presence of a true pseudoarthrosis at the fracture site, or previous prolonged treatment of the initial fracture with external fixation. Partial fibulectomy proved to be a relatively effective and simple method for the treatment of ununited fractures of the tibial shaft.