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Treatment of low-energy tibial shaft fractures: plaster cast compared with intramedullary nailing

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We analyzed data from 87 patients who had displaced closed or open grade I simple or spiral wedge tibial shaft fractures caused by low-energy impact. Fifty-four patients were treated with plaster cast and 33 with intramedullary locking nail (IMLN). Delayed union only occurred in 8 patients after plaster cast treatment. Forty-two patients in the IMLN group and one in the plaster cast group suffered from anterior knee pain. Final treatment outcome, healing time, hospitalization time and duration of sick leave were assessed on the basis of 25 matched pairs of patients. Mean healing time, hospitalization time and sick leave in the plaster cast and IMLN groups were 19 (SD 6.7) and 12 (SD 4.4) weeks (P<0.001); 8 (SD 4.8) and 7 (SD 2.7) days (P=0.686); and 195 (SD 81) and 106 (SD 31) days (P=0.001), respectively. No difference was found between plaster cast and IMLN groups when the outcome was evaluated using the criteria of Johner and Wruhs.


Nous avons étudié rétrospectivement 87 malades présentant une fracture de la diaphyse tibiale avec déplacement minime ou modéré. Parmi eux, 53 ont été traités par immobilisation plâtrée (groupe 1) et 34 par un enclouage intramédullaire (IMLN) (groupe 2). Un retard de consolidation a été observé seulement dans groupe 1 (8 patients). Une séquelle douloureuse du genou a été observée chez un patient du groupe 1 et chez 42 patients du groupe 2 . La durée de consolidation a été respectivement 19 (SD 6.7) semaines et 12 (SD 4.4) semaines (P<0.001), la durée d'hospitalisation 8 (SD 4.8) jours et 7 (SD 2.7) jours respectivement (P=0.686), et la durée du congé maladie 195 (SD 81) et 106 (SD 31) jours (P=0.001). En évaluant le résultat final selon les critères de Johner et Wrush, il n'y a pas de différence significative entre les deux groupes.

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Toivanen, J., Honkonen, S., Koivisto, AM. et al. Treatment of low-energy tibial shaft fractures: plaster cast compared with intramedullary nailing. International Orthopaedics (SICOT) 25, 110–113 (2001).

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