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Nonunions of the Tibial Plateau and Proximal Tibial Metaphysis

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Nonunions

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Abstract

Nonunion of the proximal tibia is relatively rare. For purposes of evaluation and treatment, these injuries are best divided into intra-articular and proximal metaphyseal types. Before proceeding with treatment, there must be a thorough workup for possible infectious and metabolic causes of nonunion. The appraisal also demands a thorough assessment of deformity in all planes. Definitive treatment is dictated by the location and presumed cause of nonunion, but options include plate and screw fixation for articular nonunions, and ring fixators, plate and screws, or intramedullary nailing for proximal metaphyseal nonunions. Autogenous autograft is a mainstay of treatment and will be utilized in most cases. There are scarce definitive outcomes data, but surgical intervention that includes correction of the mechanical axis, compression, and bone grafting will most often yield satisfactory functional results. This chapter reviews the patient evaluation, the assessment of deformity, and definitive treatment options.

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Authors and Affiliations

  1. Chief of Orthopaedic Trauma, Richard L. Stimson Presidential Endowed Chair, Department of Orthopedics, University Orthopedic Center, University of Utah Health Sciences, 590 Wakara Way, Salt Lake City, UT, 84108, USA

    Thomas F. Higgins MD

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  1. Thomas F. Higgins MD
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Correspondence to Thomas F. Higgins MD .

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  1. Boerne, Texas, USA

    Animesh Agarwal

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Higgins, T.F. (2018). Nonunions of the Tibial Plateau and Proximal Tibial Metaphysis. In: Agarwal, A. (eds) Nonunions. Springer, Boston, MA. https://doi.org/10.1007/978-1-4939-7178-7_12

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  • DOI: https://doi.org/10.1007/978-1-4939-7178-7_12

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  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4939-7176-3

  • Online ISBN: 978-1-4939-7178-7

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