title: Soft tissue and biomechanical challenges encountered with the management of distal tibia nonunions.
abstract: A thoughtful treatment algorithm is required to optimally treat distal tibia nonunion. A healthy respect for the tenuous soft tissue envelope, compromised vascularity, and challenging mechanical environment is advisable. Achieving osseous union and improved functionality requires an individualized plan of care based on the personality of the nonunion and host. Attention must be focused on providing mechanical stability at the site of nonunion and providing biologic supplementation.
authors.affiliation: Department of Orthopedic Surgery, Division of Traumatology, University of Pittsburgh, 3471 Fifth Avenue, Suite 911, Pittsburgh, PA 15213, USA. tarkinis@upmc.edu
authors.forename: Ivan S
authors.initials: IS
authors.lastname: Tarkin
authors.forename: Peter A
authors.initials: PA
authors.lastname: Siska
authors.forename: Boris A
authors.initials: BA
authors.lastname: Zelle
mesh_terms: D001696:Biomechanical Phenomena; D016025:Bone Transplantation / Q000379:methods*; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology*; D005599:Fractures, Ununited / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D013524:Surgical Flaps / Q000098:blood supply*; D013978:Tibial Fractures / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome