Blade plate reconstruction of metaphyseal nonunion of the tibia.

Sixteen patients with nonunion of the metaphyseal region of the proximal or distal tibia after fracture or reconstructive procedures were surgically treated using a fixed angle blade plate and autogenous bone grafting. Eight of these nonunions were complicated by prior sepsis. The average time of followup assessment was 23 months. Fourteen of these 16 nonunions went on to uncomplicated union after the index procedure. Failure of the tibial fracture to unite in 2 patients required further surgical intervention with a ring external fixator. The authors recommend blade plate reconstruction for metaphyseal nonunion of the proximal and distal tibia, especially when complicated by angular deformity, small osteopenic metaphyseal fragments, and stiff adjacent joints.