Revision of 120 tibial infected non-unions with bone and soft tissue loss treated with epidermato-fascial osteoplasty according to Umiarov

Ankle Salvage Following Nonunion of Distal Tibia Fractures

“…Restoration of functional status relies on adequate bone union, resolution of any discrepancy in limb length, and alignment of the tibial plafond. 21,22 The poor quality of bone at the site of nonunion, the proximity to the joint space, and the complexity of the operative approach make achieving functionality difficult regardless of the operative technique or type of fixation used. 13,33 Given the complexity of the pathology and the frequent presence of a comorbid infection of the nonunion, revision surgery with ankle fusion is frequently pursued.…”

What’s New in Limb Lengthening and Deformity Correction

“…Five patients with tibial nonunions and bone loss were treated successfully with acute shortening and bone-grafting and gradual lengthening over a nail via a corticotomy at a different portion of the affected tibia 70 . Other reported methods for managing posttraumatic skeletal defects or voids include the induced membrane technique 71 , hybrid grafting using demineralized bone matrix and tricalcium phosphate 72 , nonvascularized fibular strut bone grafts 73 , combined Papineau debridement and Ilizarov bone transport with postoperative negative-pressure wound closure 74 , epidermatofascial osteoplasty 75 , and use of megaprostheses 76 .…”