Medical Case Reports

Biography

Biography: Francis Yu-Sing Chan

Abstract

Introduction: While simultaneous tibia & fi bula shaft fractures are not uncommon in both routine trauma & sport related trauma (with seventy fi ve per cents of tibia fractures have associated fi bula fractures), tibia fractures have long been regarded as the main injury and surgeons attention 'and surgical treatments are as a result focused on the tibia fractures. With the abundant soft tissues attachments to the fi bula, the traditional wisdom informs us that fi bular non-union is uncommon. Once the tibia fractures have been stabilised, the fi bula fracture would commonly united usually prior to the tibia fractures union. In the residual small number of fi bula non-union, persistent symptoms from the non-union is even rare. Th us, very little was known or published on symptomatic fibula fractures non-union following the associated tibia fracture union is achieved. In the limited literature available, while there was reported use of surgery or other non-invasive methods in the treatment of symptomatic fi bular non-union, there has been no reported use of non-invasive ultrasound bone stimulator. In this study, we reported the use of ultrasound bone stimulator in this rare symptomatic non-union. Objective: 1. To report a rare symptomatic fibula fracture non-union following tibia fracture union in a keen sports woman. 2. Th e first documented assessment of the eff ectiveness of Ultrasound Bone Stimulator in the treatment of the rare symptomatic fibula non-union. Results: On completion of the 20 weeks period of ultrasound bone stimulator treatment, the patient's right leg symptoms have completely resolved and she has returned to skiing and water skiing without further symptoms. The fibular fracture was also confi rmed to be united radiological. Conclusions: With its abundant soft tissues attachment, it has long been claimed that fibula fracture has the ideal environment for union to occur. Hence, fi bula fracture non-union is rare. In previous study of 440 patients who sustained both tibia and fi bula fractures, the reported incidence of (symptomatic and asymptomatic) radiological fi bula non-union is less than 1% and symptomatic fibula non-union is less than 0.25%. In this study, the symptomatic fi bula fracture non-union following the tibia fracture union constitutes a rare clinical situation. Review of the literature has shown treatments with electrical stimulation, and/ or surgical interventions (e.g. resection of distal fragment, internal fi xation with/ without bone graft etc.). In this study, we reported the fi rst successful use of ultrasound bone stimulator in its treatment.