Previous | Next
Proximal Third Tibia Fractures Medscape
Proximal Tibia Fractures
In several recent publications, malalignment, delayed union and nonunion have been noted in fractures of the proximal one third of the tibia when these fractures have been treated with intermedullary nailing. In separate publications, Lang and associates and Johnson and colleagues. encountered multiple problems after intermedullary nailing of such fractures. These included many fractures with angulation of greater than 5ΒΊ. Loss fixation occurred in 25% of patients, and there was greater than 1 cm of displacement in 59% of injuries treated. In one series, multiple adjuvant procedures were required to obtain union. Some have suggested modifications in the proximal tibial entry site to solve the problem of malalignment that occurs on insertion of the intermedullary rod.
Lost in these discussions was the possibility of treating closed proximal third tibial fractures with nonoperative methods. One paper presented evaluated a series of patients that were first treated with a long leg cast, then converted to functional braces, and followed to union.
Type: Reference Material
Submitted by: admin
Added: Sun Sep 04 2005
Last Modified: Sun Mar 22 2009