Case Study: Healing a Tibial Non-Union with A Fibular Osteotomy | Penn Medicine

Heather, a passionate roller derby player, broke her tibia in a sports injury and had a rod placed in the bone. Months later, she was still experiencing pain at the fracture site and decided to see a Penn orthopaedic specialist. 

Samir Mehta, MD, Co-Director of the Penn Orthoplastic Limb Salvage Center, performed a CT scan and discovered a nonunion of the tibia bone. 

After discussing possible treatment approaches with Heather, including a wait and see approach, Dr. Mehta decided to go in an unconventional route which led to total healing and no pain. 

“She had broken her tibia, but not her fibula,” Dr. Mehta explained. “Because the fibula hadn’t broken, my hypothesis at least was the fibula was taking some of the load from the tibia, and not allowing the tibia to compress and heal.” 

“When we did her surgery, we took out the existing rod that was there,” Dr. Mehta continued. “We actually broke her fibula—we did an osteotomy of her fibula—to create a fracture there, then we put a new rod in and, from a technical perspective, we compressed the fracture in the operating room.” 

These adjustments – millimeters of bone compression – new screws were put in, and allowed Heather to walk almost immediately. Six weeks after surgery, the patient no longer had leg pain. 

Related Links:

Malunion and Nonunion Fractures
Four Factors for Fracture Healing: Treatment of Nonunion and Malunion 
Complex Limb Reconstruction at the Penn Orthoplastic Limb Salvage Center
Personalized 3D Printing Implants for Post-Traumatic Reconstruction After Complex Orthopaedic Injury

 

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