Fractures of the shaft of the tibia treated with AO-compression osteosynthesis

Ninety-six displaced fractures of the shaft of the tibia in a series of 162 consecutive fractures were treated by AO internal fixation. Forty per cent were open fractures, of which 93 per cent received prophylactic treatment with antibiotics at the time of admission. The average time between the accident and the operation was 10 hours in closed fractures and 5 hours in open fractures. All cases were operated on by senior surgeons. The infection rate was 5.3 per cent in closed fractures, and 0 in open fractures. The average stay in hospital was 13 days. More than 90 per cent returned to work within 6 months after the accident. No case of pseudarthrosis or re-fracture was seen. The median time to final review was 36 months. Rigid internal fixation is advocated for all displaced fractures of the shaft of the tibia and is advocated as an urgent procedure especially in open fractures, and should be performed by experienced surgeons only. Rigid internal fixation appears to provide effective prophylaxis against secondary soft-tissue damage and limits the consequences of the initial soft-tissue damage.