Simultaneous Correction of a Tibia Deformity and Non-union in Achondroplasia: A Case Report

Tibial non-union with deformity in abnormal bone is rarely reported in literature. We report a case of a 65 years old male with a history of achondroplasia. The patient presented after a mechanical fall with an undisplaced right midshaft tibia fracture associated with pre-existing varus and procurvatum tibial deformities, which was initially managed non-operatively. However, after nine months he developed a painful non-union. Because of the symptomatic non-union as well as the pre-existing deformities, osteotomy of the tibia and fibula was performed with the application of a Truelok-Hexapod (TL-Hex, Orthofix) frame. We were able to achieve compression at the fracture site, and the software guided TL-Hex frame enabled gradual three-dimensional correction of the deformity. At six months, bony union and simultaneous correction of the tibia deformity were achieved. At two years, the patient was able to ambulate well without pain and perform his activities of daily living. We present a case of tibial non-union with pre-existing deformity in an achondroplasia patient successfully treated with a circular frame application.