Proximal Tibia Plating Failed Fixation

Assessment of initial injury and patient features will result in thoughtful treatment planning, including surgical timing, surgical approach, implant selection and surgical technique. When fractures fail to unite primarily, factors within the initial fracture alignment and mechanics of fixation, along with optimization of patient medical, mental and social factors, may afford opportunity to successfully achieve healing of the nonunion. The mainstay of proximal tibia shaft plating for failed open reduction and internal fixation (ORIF) involves debridement of the nonunion, augmentation of local biology (unless the nonunion is hypertrophic) and compression of the nonunion to maximize the likelihood of successful healing.