Functional treatment of closed segmental fractures of the Tibia

A. Sarmiento, L. L. Latta

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Purpose of the study: Segmental tibial fractures are commonly believed to be more difficult to manage, requiring surgical treatment. Our experience with forty-eight segmental tibial fractures suggests that these fractures, if closed and with shortening of an acceptable initial degree and a corrected deformity, may be successfully treated with functional braces. Material and methods: Forty-eight closed segmental fractures of the tibia that had initial shortening ≥12 mm and angular deformity manually corrected to ≥7 degrees were stabilized in an above-the-knee cast for a median time of 33 days and a mode of 15 days. They were subsequently stabilized in a functional brace that allowed unencumbered motion of all joints. All other segmental fractures outside the established parameters were managed by other methods. Results: All fractures healed at a median time of 15.3 weeks. The final shortening was 4.7 millimeters with a mode of 12 millimeters. The maximum shortening was 14 millimeters. Fractures healed with a medial-lateral (M.L) angular deformities ranging zero to 19 degrees, a median of 5.9 degrees and a mode of 3.4 degrees. Conclusion: The relatively early introduction of weight bearing and the freedom of motion of all joints that the brace permits seem to result in motion at the fracture site, which in turn enhances osteogenesis. As we have previously documented, the initial shortening that closed tibial fractures experience does not increase with the physiological use of the extremity. The final shortening and angulation observed in most of the fractures should not be considered complications, simply inconsequential deviations from the normal. The same should apply to closed segmental fractures.

Original languageEnglish (US)
Pages (from-to)325-331
Number of pages7
JournalActa Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Volume75
Issue number5
StatePublished - Oct 1 2008

Keywords

  • Conservative treatment
  • Functional bracing
  • Segmental tibial fractures

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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