Bilateral fractures of the tibia: a severe injury associated with multiple trauma

Trauma which results in bilateral fractures of the tibia represents a serious physical insult to the victim. A review of our experience at the Harborview Medical Center in the treatment of 14 consecutive patients with this injury provides insights into the management of multiply injured patients with long bone fractures. All of the 28 tibial fractures were the result of high-energy forces, and 16 were open injuries. Thirteen of the patients had sustained severe multiple trauma and three died as a result of their injuries. All surviving patients were followed until complete healing and long-term followup examination was obtained. The severe injuries which result in bilateral tibial fractures are associated with a high morbidity and mortality. Aggressive and meticulous management of the bony and soft-tissue injuries can provide for good results, early mobilization, and full functional return in these multiply injured patients. Primary amputation should be undertaken only as a final alternative, as most open fractures are salvageable.