Audit of closed tibial fractures: what is a satisfactory outcome?

We performed an audit of closed non-articular tibial fractures that presented to a teaching hospital during 1 year. A total of 52 fractures in 51 patients was seen. We found that the great majority of fractures occurred in the third quarter of the tibia. Standards are essential for audit, but on review of the literature we found wide discrepancy between the standards set to judge the outcome of tibial fractures. Depending on the standards selected, we can show that 4 per cent or 42 per cent of our patients can be said to have a suboptimal outcome. We found that there is little hard evidence to support the published standards. Long-term studies of tibial fractures are required to derive rational standards to allow the most effective and efficient treatment of each case and to enable surgeons to make a meaningful audit of their results.