Skip to main content
SpringerLink
Log in
Book cover

Orthofix External Fixation in Trauma and Orthopaedics pp 275–285Cite as

Diaphyseal Fractures of the Tibia: Defining the Place of External Fixation

  • Chapter

  • 537 Accesses

Abstract

The management of tibial diaphyseal fractures is frequently rationalised into a simple regimen of one type of treatment for all injuries. Any treatment modality, however, has the potential for post-treatment complications. This means that the clinician should have both an understanding of the risks and benefits of a treatment and the necessary skills to apply it. The availability of a variety of treatments which can be applied in appropriate situations avoids the dependence upon a single treatment policy with its attendant complications.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Alho A, Ekeland A, Stromsoe K, Folleräs G, Björn OT. Locked intramedullary nailing for displaced tibial shaft fractures. I Bone Joint Surg. [Br] 1990;72-B:805–9.

    Google Scholar 

  • Alho A, Benterud JG, Hogevold HE, Ekeland A, Stromsoe K. Comparison of functional bracing and locked intramedullary nailing in the treatment displaced tibial shaft fractures. Clin Orthop. 1992;277:243–50.

    PubMed  Google Scholar 

  • Anderson R and Burgess E. ‘Delayed union and non-union’. J Bone Joint Surg. 1943;25:427–32.

    Google Scholar 

  • Andriole VT, Nagel DA, Southwick WO. A paradigm for human chronic osteomyelitis. J Bone Joint Sur [Am] 1973;55-A: 1511–15.

    Google Scholar 

  • Anglen J, Unger D, DiPasquale T, Herscovici JD, Snoke J, Sanders R. The treatment of open tibial shaft fractures using an undreamed interlocked nail – is external fixation obsolete, J Orthop. Trauma, 1993;7:163.

    Article  Google Scholar 

  • Bach AW and Hansen ST. Plates versus external fixation in severe open tibial shaft fractures. Clin Orthop. 1989;241:89–94.

    PubMed  Google Scholar 

  • Baker JT, McKinney LA, Costa AS, Nepola JV, Marsh LJ, Rodkey WG. Comparison of infection rates in contaminated tibial fractures stabilised with internal vs external fixation in rabbits. J Orthop, Trauma. 1992;6:509–10.

    Article  Google Scholar 

  • Behrens F and Searls K. External fixation of the tibia. Basic concepts and prospective evaluation. J Bone Joint Surg. 1986;68-B:246–54.

    Google Scholar 

  • A report by the BOA/BAPS working party on severe tibial injury. The early management of severe tibial fractures: The need for combined plastic and orthopaedic management. 1993.

    Google Scholar 

  • Bone LB and Johnson KD The treatment of tibial fractures by reaming and intramedullary nailing. J Bone Joint Surg. 1986;68-A:877–87.

    Google Scholar 

  • Cattermole HR, Hardy JRW, Gregg PJ. The footballer’s fracture. Br J Sports Med 1996; 30:171–5.

    Article  PubMed  CAS  Google Scholar 

  • Caudle RJ and Stern PJ. Severe open fractures of the tibia. J. Bone Joint Swrg 1987;69-A:801–7.

    Google Scholar 

  • Centres for Disease Control: Recommendations for Prevention of Human Immunodeficiency Virus (HIV) Transmission in Health Care Settings. M M W R 1987; 36(Suppl 2S):1–18.

    Google Scholar 

  • Centres for Disease Control: Update: Universal Precautions for Prevention of Transmission of Human Immunodeficiency Virus, Hepatitis B Virus, and other Blood-borne Pathogens in Health Care Settings. M M W R. 1988;37(24):377–482.

    Google Scholar 

  • Checketts RG, Moran CG, Jennings AG. 134 tibial shaft fractures managed with the DynamicAxialFixator. Acta Orthop Scand 1995;66(3):271–4.

    Article  PubMed  CAS  Google Scholar 

  • Charnley J. The Closed Treatment of Common Fractures. Churchill Livingstone, London. 3rd Ed. 1961.

    Google Scholar 

  • Clancey GJ and Hansen ST. Open fractures of the tibia. Bone Joint Surg. [Am] 1978;601 A:118–122.

    Google Scholar 

  • Court-Brown CM, McQueen MM, Quaba AA, Christie J. Hughes external fixator in treatment of tibial fractures. J Royal Soc Med. 1985;78:830–7.

    CAS  Google Scholar 

  • Court-Brown CM, Wheelwright EF, Christie J, McQueen MM. External fixation for type III open tibial fractures. J Bone Joint Sur. [Br] 1990a; 72-B: 801–4.

    Google Scholar 

  • Court-Brown CM, Christie J, McQueen MM. Closed intramedullary tibial nailing. J Bone Joint Sur. [Br] 1990b; 72-B: 605–11.

    Google Scholar 

  • Court-Brown CM, McQueen MM, Quaba AA, Christie J. Locked intramedullary nailing of open tibial fractures. J Bone Joint Surg. 1991; 73-B: 959–64.

    Google Scholar 

  • Court-Brown CM, McBirnie J. The epidemiology of tibial fractures. J Bone Joint Sur. [Br] 1995; 77-B: 417–21.

    Google Scholar 

  • Dellinger EP, Caplan ES, Weaver LD, Wertz MJ, Droppert BM, Hoyt N, Brumback R, Burgess A, Poka A, Benirschke SK, Lennard ES, and Lou MA. Duration of preventive antibiotic administration for open extremity fractures. Arch Surg. 1988a; 123: 333–9.

    PubMed  CAS  Google Scholar 

  • Dellinger EP, Miller SD, Wertz MJ, Grympa M, Droppert BM, Anderson PA. Risk of infection after open fracture of the forearm or leg. Arch Surg 1988b; 123: 1320–7.

    PubMed  CAS  Google Scholar 

  • Ellis H. The speed of healing after fracture of the tibial shaft, J Bone Joint Sur. 1958a; 40-B: 42–6.

    CAS  Google Scholar 

  • Foxworthy M and Pringle RM. Dynamisation timing and its effect on bone healing when using the Orthofix Dynamic Axial Fixator. Injury. 1995;26(2):117–9.

    Article  PubMed  CAS  Google Scholar 

  • Gerberding JL, Littel C, Tarkington A, Brown A, Schecter WP. Risk of Exposure of Surgical Personnel to Patients Blood During Surgery at San Francisco General Hospital. New Eng J Med. 1990; 21: 1788–93.

    Article  Google Scholar 

  • Green RA. The courage to co-operate: the team approach to open fractures of the lower limb. Ann R Coll Surg Engl. 1994; 76:365–6.

    PubMed  CAS  Google Scholar 

  • Gustilo RB and Anderson JT. Prevention of infection in the treatment of one thousand and twenty-five fractures of long bones. Bone Joint Surg [Br] 1976; 58-A: 453–

    Google Scholar 

  • Gustilo RB, Mendoza RM, Williams DN. Problems in the management of Type III (Severe) open fractures: A new classification of type III open fractures. The Journal of Trauma. 1984;24(8):742–6.

    Article  PubMed  CAS  Google Scholar 

  • Gustilo RB and Gruninger RP. Classification of Type III (Severe) Open fractures relative to treatment and results. Orthopaedics. 1987;10:1781–028.

    CAS  Google Scholar 

  • Gustilo RB, Merkow RL, Templeman D. Current Concepts Review -The management of open fractures. Bone Joint Surg. [Am] 1990; 72-A: 299–303.

    Google Scholar 

  • Hardy JRW, Richardson JB, Gregg PJ. Creating an early stable environment for healing by callus: The Leicester algorithm. International Journal of Orthopaedic Trauma. 1996; 6(2): 52–61.

    Google Scholar 

  • Keating JF, Gardner E, Leach WJ, Mcpherson S, Abrami G. Management of tibial fractures with the Orthofix Dynamic External Fixator. J R Coll Surg Edinb. 1991; 36: 272–7.

    PubMed  CAS  Google Scholar 

  • Marsh JL, Nepola JV, Wuest TK, Osteen D, Cox K, Oppenheim W. Unilateral External Fixation until healing with the Dynamic Axial Fixator for severe open tibial fractures: J Orthop Traumas. 1991; 5(3): 341–8.

    Article  CAS  Google Scholar 

  • Müller ME, Nazarian S, Koch P, Schatzker, J. The Comprehensive Classification of Fractures of Long Bones. 1990; Springer-Verlag, Berlin-Heidelberg-New York.

    Google Scholar 

  • Nicoll EA. Fractures of the tibial shaft - A survey of 705 cases. Bone Joint Surg. [Br] 1964; 46-B: 373–87.

    Google Scholar 

  • North AD, Wallace WA, Howard PW, Newton G. Management of tibial diaphyseal fractures with primary dynamic external fixation: a prospective study. J Bone Joint. [Br] 1990; 72-B: 531.

    Google Scholar 

  • Oni OOA, Hui A, Gregg PJ. The healing of closed tibial shaft fractures - The natural history of union rvit c osed treatment. J Bone Joint Surg. [Br] 1988a; 70-B: 787–90.

    Google Scholar 

  • Oni OOA, Gregg PJ, Morrison C, Ponter ARS. An investigation of the fracture characteristics of the tibia of mature rabbits. Injury. 1988b; 19: 172–6.

    Article  PubMed  CAS  Google Scholar 

  • Pennig D. The place of unilateral internal fixation in the treatment of tibial fractures. International Journal of Orthopaedic Trauma. 1991;1(3):161–76.

    Google Scholar 

  • Rang M. Children’s Fractures. 2nd Edition. J B Lippincott Company, Philadelphia. 1984.

    Google Scholar 

  • Ribbans WJ and Saleh M. Orthofix External Fixation for tibial fractures. J Bone Joint Sur. [Br] 1991; 73-B [SUPP II]:177.

    Google Scholar 

  • Robinson D, On E, Hadas N, Hofman S, and Boldur I. Microbiological flora contaminating open fractures: Its significance in the choice of primary antibiotic agents and the likelihood of deep wound infection. The Journal of Orthopaedic Trauma. 1989; 3: 283–6.

    Article  CAS  Google Scholar 

  • Tscherne H and Götzen L. Fractures with soft tissue injuries. Springer-Verlag. New York, Heidelberg and Berlin. 1984.

    Google Scholar 

  • Veliskakis K P. Primary internal fixation in open fractures of the tibial shaft - the problem of wound healing. J Bone Joint Surg. [Br] 1959; 41-B: 342–54.

    CAS  Google Scholar 

  • Velazco A, Whites ides TE, Fleming LL. Open fractures of the tibia treated with the Lottes nail, J Bone Joint Surg. [Br] 1983; 65-A: 879–85.

    Google Scholar 

  • Watson JT. Treatment of unstable fractures of the shaft of the tibia, J Bone Joint Surg [Am] 1994; 76-A: 1575–84.

    Google Scholar 

  • Weissman SL, Herold HZ, Engleberg M. Fractures of the middle two-thirds of the tibial shaft. J Bone Joint. [Am] 1966; 48-A: 257–67.

    Google Scholar 

  • Wilkins J and Patzakis MJ. Choice and duration of antibiotics in open fractures. Orthopaedic Clinics of North America. 1991; 22: 433 7.

    CAS  Google Scholar 

  • Wiss DA. Flexible medullary nailing of acute tibial shaft fractures. Clin Orthop 1986; 212: 122–32.

    PubMed  Google Scholar 

  • Wu Y-S and Zhang F-B. The treatment of tibial and fibular fractures with the rectangular intramedullary nail. Orthopaedics. 1994; 2(5): 437–46.

    Google Scholar 

Download references

Authors
  1. J. R. W. Hardy
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. B. Richardson
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Orthofix® srl, Via delle Nazioni, 9, 37012, Bussolengo (Verona), Italy

    Anthony Goldberg MBBS, MPharm, FFPM (Group Medical Director) (Group Medical Director)

Rights and permissions

Reprints and permissions

Copyright information

© 2000 Springer-Verlag London Limited

About this chapter

Cite this chapter

Hardy, J.R.W., Richardson, J.B. (2000). Diaphyseal Fractures of the Tibia: Defining the Place of External Fixation. In: De Bastiani, G., Apley, A.G., Goldberg, A. (eds) Orthofix External Fixation in Trauma and Orthopaedics. Springer, London. https://doi.org/10.1007/978-1-4471-0691-3_26

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-0691-3_26

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-1178-8

  • Online ISBN: 978-1-4471-0691-3

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation