Fractures of the tibial shaft: is medical audit possible?

Eight reports dealing with fractures of the tibial shaft have been examined to ascertain whether an audit of the results could be made. This was possible in only two instances owing to wide variations in the systems of classification of fractures, in definitions of certain terms and in presentation of results. Histograms in the form of frequency distribution curves of healing time were not helpful for making comparisons but the presentation of the results in the form of cumulative percentage curves appears to have advantages as a simple visual means of comparison. Statistical analysis is then still necessary. Little useful information is gained by attempting to compare reports which incorporate different systems of classification and definition as well as different methods of presenting results. A medical audit of different methods of treatment will only be made possible by standardization in these matters. A system of classification is required which will subclassify serious fractures so that specific problem fracture types can be studies on a multicentre basis.