Fibular nonunion in combination with fractures of the tibia

Seventeen cases of fibular nonunion or delayed union were seen in our institution from 1985 to 1990. All but one of these cases were associated with nonunion of the tibia which was diagnosed radiologically and/or surgically. The fibula characteristically heals before the tibia; therefore, if the fibula is slow in healing or showing nonunion, more intensive investigation of the tibia for occult nonunion, or delayed union, should be done to determine whether early surgical intervention would be necessary to avoid prolonging the course of treatment. Nonunion of the fibula may indicate instability of the fractured tibia. The authors have examined the relationship of this mutual nonunion and recommend careful observation of the fibular healing in associated fractures of the tibia and fibula.