Despite the improved rate of union reported with early weight-bearing in
tibial shaft fractures, there continues to be a small number of patients
with delayed union and non-union who present a dilemma to the surgeons.
Partial fibular ostectomy (fibulectomy) is one means of promoting union in
ununited fractures of the tibia. Fifty-one patients at our hospital
underwent that treatment between December 1, 1971 and June 30, 1979, at
twenty to fifty-nine weeks after the date of injury. Following the partial
fibulectomy, 77 per cent of the tibial fractures healed. Failure of union
after fibulectomy was associated with either failure of the patient to bear
weight postoperatively, the presence of a true pseudarthrosis at the
fracture site, or previous prolonged treatment of the initial fracture with
external fixation. Partial fibulectomy proved to be a relatively effective
and simple method for the treatment of ununited fractures of the tibial
shaft.