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Related Concept Videos

Fractures: Bone Repair01:27

Fractures: Bone Repair

Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...
Bones of the Lower Limb: Tibia and Fibula01:10

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The tibia is the main weight-bearing bone of the lower leg. It is larger than the fibula with which it is paired. The tibia is also the second longest bone in the body and is located right below the skin. The proximal end of the tibia forms the medial and the lateral condyle, which articulates with the condyles of the femur to form the knee joint. Between the articulating surfaces is the irregular elevated area known as the intercondylar eminence that serves as the inferior attachment point for...

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Creating Rigidly Stabilized Fractures for Assessing Intramembranous Ossification, Distraction Osteogenesis, or Healing of Critical Sized Defects
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Published on: April 11, 2012

Operative fixation for complex tibial fractures.

A J P Hutchinson1, A E Frampton, R Bhattacharya

  • 1Department of Physiotherapy, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK. amanda.hutchinson@imperial.nhs.uk

Annals of the Royal College of Surgeons of England
|April 25, 2012
PubMed
Summary

For open tibial shaft fractures, intramedullary nailing and external fixation show similar outcomes. Current evidence does not strongly favor one fixation technique over the other for fracture union, infection, or complications.

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Area of Science:

  • Orthopedic Surgery
  • Trauma Management

Background:

  • Open tibial shaft fractures present significant management challenges.
  • Intramedullary nailing and external fixation are primary surgical interventions.
  • Optimal fixation technique for these fractures is not definitively established.

Purpose of the Study:

  • To compare the outcomes of intramedullary nailing versus external fixation for open tibial shaft fractures.
  • To evaluate time to union, infection rates, and complication profiles.

Main Methods:

  • A systematic literature review was performed using MEDLINE and MeSH terms.
  • Studies published in English between 1999 and 2009 were included.
  • Key outcome measures included fracture union time, infection, and complications.

Main Results:

  • Three studies met inclusion criteria from an initial 41 identified.
  • Variable time to union was observed across studies.
  • External fixation showed a trend towards higher delayed/non-union rates, though not statistically significant.
  • Both methods were associated with secondary procedures and infections.

Conclusions:

  • Limited evidence exists to support the superiority of either intramedullary nailing or external fixation for open tibial fractures.
  • Further high-quality research is needed to guide optimal treatment selection.