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BACKGROUND: Tibial nonunion is disabling, but to our knowledge no quantitative evaluation of its effect on health-related quality of life has been reported. METHODS: We evaluated 243 tibial shaft fracture nonunions in 237 consecutive patients (seventy-nine female age, 49.4 ± 14.9 years and 158 male age, 46.3 ± 15.4 years) who were referred to a single surgeon at our tertiary care center over a ten-year period. The most frequently affected tibial segment was the distal third (49%), and infection was present in 18% of all cases. RESULTS: The Short Form (SF)-12 Physical Component Summary score averaged 27.4 ± 6.7, indicating an extremely disabling effect on physical health. The AAOS (American Academy or Orthopaedic Surgeons) Lower Limb Core Scale score averaged 52.0 ± 19.4, also consistent with high levels of physical disability attributable to the lower limb. The SF-12 Mental Component Summary score averaged 42.3 ± 7.1, indicating a substantial detrimental effect on mental health. CONCLUSIONS: The impact of tibial shaft fracture nonunion on physical health was comparable with the reported impact of end-stage hip arthrosis and worse than that of congestive heart failure. Tibial shaft fracture nonunion is a devastating chronic medical condition that negatively affects both physical and mental health and quality of life.
Brinker et al. (Sun,) studied this question.