Distal Third Tibial Nonunions: Understanding Its Causes and Ring Fixator Treatment Strategies.

Luzzi, Richard; Hanchar, Jonathan; Pacheco Fernandes, Rodrigo Mota · Foot Ankle Clin · 2026

review · Level V

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Abstract

Distal third tibial nonunion is a challenging clinical scenario for orthopedic surgeons. Despite advancements in surgical techniques and implant designs, these patients continue to pose a significant burden on their quality of life and health care systems. This review aims to provide a short overview of the etiology, pathophysiology, diagnostic approaches, and classification systems, emphasizing the comprehensive treatment strategies. Focusing on clinical experience and practice, this article aims to enhance the understanding of distal third tibial nonunion and guide clinicians in optimizing patient outcomes.

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