Challenges and controversies in defining and classifying tibial non-unions

Abstract

Tibial non-unions not only result in significant physical impairment but also serve as a source of considerable psychological and socio-economic stress for the patient. Unnecessary delays in recognising potential non-unions lead to treatment delays that further exacerbate the morbidities associated with non-unions. Current definitions are not universally accepted and are considered by some to be too esoteric for general use.

The lack of clear defining criteria for non-union may result in delays in diagnosis and appropriate management. The most frequently used classification systems currently are more than 30 years old and do not take new knowledge of biology and modern treatment modalities into account.