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Non-union in open tibial fractures
The Journal of Bone and Joint Surgery. American Volume
|March 1, 1977
Summary
Open tibial shaft fractures, often from vehicle accidents, have high non-union and infection rates. Inadequate wound care and internal fixation contributed to treatment failures in this study.
Area of Science:
- Orthopedic Surgery
- Trauma Care
- Bone Healing Research
Background:
- Open tibial shaft fractures present significant challenges in achieving union and preventing infection.
- Vehicular accidents are a primary cause of these severe injuries.
Purpose of the Study:
- To analyze the outcomes of open tibial shaft fractures treated at a civilian teaching center.
- To identify factors contributing to non-union and infection in these fractures.
Main Methods:
- Retrospective review of 104 cases of open tibial shaft fractures.
- Analysis of fracture causes, wound characteristics, treatment modalities, and outcomes.
Main Results:
- Seventy-one percent of fractures resulted from vehicular accidents.
- A significant 27% of fractures failed to unite, with half of these becoming infected.
- Non-unions were frequently associated with fibula fractures, extensive soft tissue damage, and contaminated wounds.
Conclusions:
- Treatment failures were linked to suboptimal wound management (premature closure, inadequate secondary closure) and the use of internal fixation.
- Early weight-bearing without internal fixation did not consistently ensure fracture union.