Evidence map›Paper›PMID 42171812›Full record

ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2026

Rate of fibular non-union in patients with tibial shaft fractures: a retrospective cohort study.

W Andrew Day, C Julian Clark, Johnathan W Riley, Drew P Melancon, Isaac J Spears, J C Davidson, Lauren Hopper, R Peyton Parker, Priyanka Nehete, Peter N Mittwede and 1 more

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Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
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1 · What the graph read from it

What it found

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

W Andrew DayUniversity of Mississippi Medical Center, Jackson, USA.
C Julian ClarkUniversity of Mississippi Medical Center, Jackson, USA. cjclark1@umc.edu.
Johnathan W RileyUniversity of Mississippi Medical Center, Jackson, USA.
Drew P MelanconUniversity of Mississippi Medical Center, Jackson, USA.
Isaac J SpearsUniversity of Mississippi Medical Center, Jackson, USA.
J C DavidsonUniversity of Mississippi Medical Center, Jackson, USA.
Lauren HopperUniversity of Mississippi Medical Center, Jackson, USA.
R Peyton ParkerDepartment of Orthopaedic Surgery, University of Tennessee Health Science Center, Chattanooga, USA.
Priyanka NeheteUniversity of Mississippi Medical Center, Jackson, USA.
Peter N MittwedeUniversity of Mississippi Medical Center, Jackson, USA.
Patrick F BerginUniversity of Mississippi Medical Center, Jackson, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeFibular non-union occurs at an unknown rate in patients with tibial shaft fractures. The purpose of this study was to assess the rate of fibular non-union in patients with tibial shaft fractures. We also assessed if any factors are associated with the rate of fibular non-union.

methodsThis was an Institutional Review Board (IRB) approved retrospective cohort study performed at a level one trauma center. We reviewed the collected data on 400 patients that had fibular fractures with associated tibial shaft fractures from June 2012 to June 2021. To meet the inclusion criteria for this study, patients 16 years and older needed a minimum of three months of follow-up and sustained fibular fractures with associated tibial shaft fractures fix with an intramedullary rod. The standard and modified radiographic union scale in tibia (RUST and mRUST) fractures score of 8 was used as the parameter to determine fibular union.

resultsThe rate of fibular non-union was 21% (84/400). Distal 1/3 fibular fractures had a higher non-union rate (25%, 46/179) than proximal and middle 1/3 fractures (12%, 10/83; 20%, 28/138 respectively) (p = 0.036). Patients that had fibular fixation went on to form a non-union at a rate of 25% (31/121) and patients that did not have fibular fixation went on to form non-union at a rate of 19% (52/279) (p = 0.114). Of the patients that did have fibular fixation, those fixed with intramedullary flexible nail (IMFN) or screw are less likely to form a non-union than those fixed with plates (p = 0.049).

conclusionThis study identified the rate of fibular non-union in patients with associated tibial shaft fractures treated with an intramedullary rod. We also identified that there is an increased risk of non-union when there is fibular fixation with plates and screws versus IMFN. We do not know the clinical implications of this, but it may be a source of pain in patients with healed tibia shaft fractures therefore we believe a prospective randomized controlled study may be warranted.

Indexed as

FibulaFibula FracturesFractures, UnunitedTibial FracturesAdultAgedFemaleFracture Fixation, IntramedullaryFracture HealingHumansMaleMiddle AgedRetrospective StudiesYoung AdultFibular non-unionFracture fixationFracture locationIntramedullary flexible nail (IMFN)Intramedullary nailingOrthopaedic traumaPlate fixationRadiographic union (RUST/mRUST)Retrospective cohort studyTibial shaft fracture

Identifiers

PMID42171812
PMCPMC13197365

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.