Operative treatment of tibial shaft fractures: a comparison of different methods of primary stabilisation View Full Text


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Article Info

DATE

2008-05-09

AUTHORS

J. Beardi, M. Hessmann, M. Hansen, P. M. Rommens

ABSTRACT

IntroductionSegmental fractures of the tibial shaft (AO type 42-C2) often occur after a high energy direct trauma with consecutive severe soft tissue injury and a high rate of open fractures. The blood supply of the intermediate bone fragment can be severely disturbed and therefore operative treatment is demanding. In this retrospective study, we compared three different methods of stabilisation.Materials and methodsWe reviewed the clinical charts and postoperative problems of 26 patients in a ten year period. Sixteen (62%) fractures were stabilised with an intramedullary nail, five (19%) fractures by plate osteosynthesis and five (19%) fractures with an external fixator.ResultsBony consolidation was obtained in all patients after an average time of 11.4 months. In 17 patients (65.4%) a second operative procedure had to be performed. Pseudarthrosis was seen in 11 fractures (40%), three times in the proximal and eight times in the distal fracture. In the intramedullary nailing group, pseudarthrosis occurred in nine patients. In the group treated with an external fixator, pseudarthrosis was seen three times. After changing to a different implant bony consolidation was achieved in every patient.ConclusionConventional intramedullary nailing is not suitable for stabilisation of segmental fracture types with a short metaphyseal fracture fragment. New nails with proximal and distal interlocking in three different planes offer better stability. Bone vascularisation should not be endangered by the stabilisation procedure and optimal reduction of the fracture is an important prerequisite for uneventful fracture healing, especially in this difficult fracture configuration More... »

PAGES

709-715

References to SciGraph publications

  • 1989-07. The difficult healing of segmental fractures of the tibial shaft in ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
  • 1999-08. Osteosynthetische versorgung proximaler extraartikulärer tibiafrakturen Indikationen, komplikationen, ergebnisse in EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY
  • 2001-07. Prinzipien der intramedullären Knochenbruchstabilisierung Teil 1 in DER UNFALLCHIRURG
  • 1980-09. Der Unterschenkeletagenbruch in EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY
  • 1986-12. Nachuntersuchungsergebnisse von 102 mit DC-Plattenosteosynthese stabilisierten Tibiaschaftfrakturen in EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY
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    URI

    http://scigraph.springernature.com/pub.10.1007/s00402-008-0619-5

    DOI

    http://dx.doi.org/10.1007/s00402-008-0619-5

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1050471035

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/18465138


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