Prabhat Vinay, Vargaonkar Gauresh S, Mallojwar Sunil R, Kumar Ramesh
Senior Resident, Central Institute of Orthopaedics, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Director Professor, Central Institute of Orthopaedics, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
J Clin Orthop Trauma. 2016 Oct-Dec;7(Suppl 1):121-124. doi: 10.1016/j.jcot.2016.03.001. Epub 2016 Mar 22.
Non-union of tibia is known to be a common complication after fracture both bones of leg treated conservatively. During the course of natural healing, fibula usually unites early as it had more soft tissue attachment and vascular supply. Due to early union of fibula and absence of axial force across the tibia, it undergoes non-union.
Two cases, a 32-year-old male and 65-year-old female treated conservatively for fracture both bones of leg long years back, presented to us with mild calf pain on and off. On radiological examination, there was non-union of tibia along with compensatory fibular hypertrophy to the extent that fibula became main weight bearing bone.
In both the cases, we observed gross fibular hypertrophy in presence of non-union of tibia.
In conservatively treated cases of fracture, both bones of leg, non-union of tibia may coexist with compensatory hypertrophy of fibula to the extent that, it becomes main weight bearing bone of the leg. We are presenting here two cases of natural tibialization of fibula along with nonunion tibia. Our article supports the theory of Wolff's law.
众所周知，小腿双骨折保守治疗后，胫骨不愈合是一种常见并发症。在自然愈合过程中，腓骨通常较早愈合，因为它有更多的软组织附着和血供。由于腓骨早期愈合且胫骨缺乏轴向力，胫骨会发生不愈合。
两例患者，一名32岁男性和一名65岁女性，多年前因小腿双骨折接受保守治疗，现偶尔出现轻度小腿疼痛前来就诊。影像学检查显示，胫骨不愈合，同时伴有代偿性腓骨肥大，以至于腓骨成为主要承重骨。
在这两例病例中，我们均观察到胫骨不愈合伴有明显的腓骨肥大。
在小腿双骨折保守治疗的病例中，胫骨不愈合可能与腓骨的代偿性肥大同时存在，以至于腓骨成为小腿的主要承重骨。我们在此展示两例腓骨自然胫骨化伴胫骨不愈合的病例。我们的文章支持沃尔夫定律。
