To analyze the factors affecting the nonunion of extraarticular proximal tibial fracture and the outcome of nonunion treatment.

We investigated 51 cases of extraarticular proximal tibial fractures from June 2002 to May 2006. The nonunion rate was assessed in relation to several risk factors and the treatment outcome of nonunion using plate fixation with bone graft was assessed by Klemm and Börner functional rating system.

6 cases of nonunion (11.8%) was noted among 51 cases, and the risk factors examined, OTA A3 comminuted fracture was associated with a high nonunion rate with statistical significance and initial bone graft had a significant effect in bone healing. Excellent and good results were obtained in 5 cases (83.3%) and bone union was achieved in all nonunion cases.

Comminution was found to be an important factor affecting the nonunion in extraarticular proximal tibial fracture, and bone graft in primary operation could reduce the chance of nonunion. Accurate plate fixation with bone graft is a reliable option in nonunion treatment.