PROXIMAL TIBIA NON-UNION WITH IPSILATERAL FRESH FRACTURE OF MID-SHAFT OF TIBIA: A CASE REPORT AND REVIEW OF LITERATURE

Proximal tibial fractures are one of the common fractures in lower extremity, when not treated properly, can cause impairment of function. Although the risk of proximal tibia non-union is relatively low after surgical treatment, there are still reported cases of non-union. Although the proximal tibial metaphyseal region has rich vascularity, non-union can occur due to poor bone quality as in osteopenia in bedridden patients, or due to the nature of trauma that damages the blood flow to the fracture fragment. When proximal tibia non-union occurs concomitantly with ipsilateral tibial mid-shaft fracture, it hinders the possibility of intramedullary interlocking nail fixation for tibial shaft fracture. We are presenting you a rare case of 1 1/2 year old surgically treated Schatzker type 6 right proximal tibia non-union along with fresh ipsilateral tibial shaft fracture treated by proximal fibular osteotomy, excision of fibrous tissue at non-union site, lifting and freshening the fracture, open reduction and internal fixation with plating augmented by cancellous bone grafting and closed reduction and internal fixation of tibia shaft fracture using Enders nails.