Proximal tibial fractures: current treatment, results, and problems

Fractures of the proximal tibia can present unique treatment challenges. Reduction and stability are dependent on control of the proximal fragment. Soft tissue compromise can present as a component of the injury, or can result from surgical dissection. Treatment protocols aimed at addressing these issues have included closed treatment, external fixation, intramedullary nailing, and plating. The issues of accurate reduction, proximal fragment stabilization, and soft tissue protection are discussed with an emphasis on the individual challenges of each of the treatment modalities.