Proximal tibial replacement with megaprosthesis in the setting of proximal tibial nonunion: A case report

Background: Fracture nonunion is a major concern among an orthopaedic patient population, especially in those who have sustained traumatic fractures involving the tibia. Strong risk factors for nonunion include age, smoking history, and a poor diet. The incidence of nonunion also increases with each...

Full description

Saved in:
Bibliographic Details
Main Authors: Ellen Lutnick, Noah M. Braun, Evgeny Dyskin, Mary Bayers-Thering
Format: Article
Language:English
Published: Elsevier 2024-10-01
Series:Trauma Case Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2352644024001109
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background: Fracture nonunion is a major concern among an orthopaedic patient population, especially in those who have sustained traumatic fractures involving the tibia. Strong risk factors for nonunion include age, smoking history, and a poor diet. The incidence of nonunion also increases with each additional failed surgical intervention. Methods: Our retrospective case study involved 56-year-old woman with a history of chronic low back pain, osteopenia, malnutrition, smoking, marijuana use, and alcohol use, who presented with a proximal tibia fracture after a fall, initial treatment included temporization with multiplanar external fixation and subsequent internal fixation. Five weeks later, she presented with atrophic nonunion. She subsequently underwent multiple unsuccessful surgeries to address her nonunion, including open repair with bone grafting and multiplanar external fixation for bone transport. Ultimately, the nonunion was addressed by proximal tibia replacement with megaprosthesis with excellent clinical results. Results and conclusion: Replacement of a proximal tibia with megaprosthesis is a viable option for limb salvage, especially when all alternative treatments have been unsuccessful.
ISSN:2352-6440