Own clinical experience with functional bracing for treatment of pseudarthrosis and delayed union of the tibia

Functional bracing is a proven method of treatment of tibial fractures. Since 1998 we use individually produced braces made of "combicast" according to Schuren technique. The brace greatly limits the angulation and displacement allowing the axial compression, promoting the physiology of fracture healing.

Functional bracing was applied in 51 patients, ageing from 18 top 69 years. The conservative treatment was previously performed in 16 patients, and 35 patients were treated surgivcally (from 1 to three surgeries in other centers). The delayed union was diagnosed in 28 patients - no signs of bone healing after 4 months after fracture. In 23 patients the pseudarthrosis of tibia was diagnosed after 6 months of treatment. In 9 patients shock wave therapy or bone marrow injection was additionally performed.

In all 35 patients, but one, who were treated only with the use of functional bracing, the bone consolidation, after 4 to 12 months of treatment was obtained. In cases with delayed union the fast normalization of blood circulation with subsidence of swelling and fast restoration of rang of the joints motion was observed. X-ray reveals fracture healing with disappearing of local osteoporosis. The patients feel comfortable and require only minimal rehabilitation. Biological stimulation can be achieved by means of shock waves or bone transplantation. No complication according to the functional brace was noted.

This safe and economic method constitues an important aid in treatment of non only acute but also of complicated tibial fractures.