Journal articles: 'Diaphyseal tibial fractures'

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Iqbal, Sajjad, Hafiz Salman Saeed, Bushra Aslam, and Iqra Fayyaz. "TIBIAL DIAPHYSEAL FRACTURES;." Professional Medical Journal 24, no. 09 (September 8, 2017): 1336–41. http://dx.doi.org/10.29309/tpmj/2017.24.09.902.

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Objectives: To evaluate the management of tibial diaphyseal fractures treated byPOP cast versus intramedullary nailing in terms of time of union. Design of study: Randomizedcontrolled trials. Setting: Department of Orthopaedic, Allied / DHQ Hospital, Faisalabad.Duration of Study: Six months (01-08-2013 to 31-01-2014). Materials and Methods: 80patients fulfilling the inclusion and exclusion criteria were included in the study. After laboratoryand radiological assessment, the patients in Group 1 were treated by long leg cast. The patientsin Group 2 were treated with intramedullary interlocking nail. The patients were followed on OPDbasis. Results: 80 patients divided into 2 groups. Each group had 40 patients. Mean age ofpatients was 30.99 ±8.092 years. There were total of 65% males and 35% females in this study.According to geometry of fractures simple transverse fractures were 47.5%, spiral fractureswere 17.5%, oblique fractures were 25% and segmental fractures were 10%. There were 71.25%closed fracture and 28.75% type l open fractures. Mean time of union was 23.86 ± 5.48 weeks ingroup 1 while in group 2, mean time of union was 18.35 ± 4.12 weeks. P-value was 0.001 whichis statistically significant. Conclusion: It is concluded that reamed intramedullary interlockingnailing is a good mode of internal fixation comparing with conservative management of closereduction and POP cast in both close and type I open fractures in terms of union.

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Davies, John, and Albert Lynch. "Percutaneous Tibial Fracture Reduction Using Computed Tomography Imaging, Computer Modelling and 3D Printed Alignment Constructs: A Cadaveric Study." Veterinary and Comparative Orthopaedics and Traumatology 32, no. 02 (February 13, 2019): 139–48. http://dx.doi.org/10.1055/s-0039-1677751.

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Objective The main aim of this study was to evaluate a percutaneous method of bone alignment using a diaphyseal tibial fracture model. Materials and Methods Mid-shaft diaphyseal fractures were created in 12 large-breed canine tibiae. Interaction pins were inserted into the proximal and distal bone segments. Computed tomography scans of the fractured tibiae and pins were imported into three-dimensional (3D) modelling software and the fractures were virtually reduced. A multi-component 3D printed alignment jig was created that encompassed the pins in their aligned configuration. Orthogonal radiographs were taken after alignment jig application. Intact and post-alignment tibial lengths and joint angles were compared. Rotational alignment was subjectively evaluated. Results Post-alignment tibial lengths differed on the mediolateral and craniocaudal radiographs by an average of 1.55 and 1.43% respectively. Post-alignment mechanical medial proximal tibial angle, mechanical medial distal tibial angle and mechanical caudal proximal tibial angle had an average difference of 1.67°, 1.92° and 2.17° respectively. Differences in tibial length and joint angles were not significant (p > 0.05). Clinical Significance While in vivo evaluation is necessary, this technique to align diaphyseal fractures percutaneously using computer modelling and 3D printing is technically feasible and may facilitate the clinical use of minimally invasive osteosynthesis techniques.

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Abbasi, Allah Nawaz, Karam Ali Shah, and Muhammad Azeem Akhund. "DIAPHYSEAL TIBIAL FRACTURES;." Professional Medical Journal 21, no. 02 (December 6, 2018): 395–99. http://dx.doi.org/10.29309/tpmj/2014.21.02.2044.

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Objective: To determine the outcome and consequences of close intramedullaryinterlocking nailing in diaphyseal tibial fractures and to observe the hospital stay & complicationsin this method of treatment. Place & Duration: The study was conducted in department oforthopaedic unit-I at Liaquat University Hospital Jamshoro/Hyderabad during Jan 2011 to June2012. Patients & Method: The present study constituted on 43 patients, 3 cases were droppedduring follow up and the rest 40 cases completed 1 year post operative follow up. After havingroutine laboratory investigations and necessary x – rays, the stable patients were operated forintramedullary interlocking nailing on routine operating days. The patients were assessedaccording to the criteria mentioned in follow up proforma from date and time of arrival to final visitin review clinic and results were tabulated. Results: Among 40 patients, 38 (95%) were males and02 (5%) females. The age ranges from 17 to 50 years with mean age of 32.23 years. There were 25close fractures (62.5%) 15 open fractures (37.5%), among these 13 (32.5%) were Gustilo type Iand 2 (5%) were of type II. The mode of injury in majority (75%) of cases was road traffic accident.Good union achieved in 39 cases (97.5%) in 17.53 weeks. But only 1 (2.5%) case unfortunatelywent in infected non union and was converted into Illizarove external Fixation. The maincomplication observed after surgery was loosening of screw in 3 (7.5%) cases. Deep infectionwas observed in the medullary cavity in 3(7.5%) cases (table-V). It has been observed inanalyzing the functional outcome of these patients that majority (80%) of cases was able to sit onbed in 12-24 hours and was able to stand in 24-48 hours. In next 24 hours after surgery 75% ofpatients were pain free. The mean hospital stay in these cases was 8.53 days and by the 48thweek all of cases were able to join their job except one case in which non union observed due toinfection. Conclusions: The data from the current study reveals that intramedullary interlockingnailing of closed and open grade I and II fractures is a safe technique. It combines a high rate ofunion with a low complication rate, less hospitalization and early return to job.

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Ahmed, Parvez, Khawand Bukhsh Umrani, Mahtab Ali Shahani, Zamir Hussain Tunio, Abdul Hafeez Qureshi, and Mohammad Aslam Mengal. "Management of open diaphyseal fracture of tibia in adults: A comparative study between plaster of paris cast versus external fixator." Professional Medical Journal 27, no. 07 (July 10, 2020): 1499–504. http://dx.doi.org/10.29309/tpmj/2020.27.07.4501.

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Objectives: To determine the management of open diaphyseal fracture of tibia with plaster of Paris (pop) cast vs external fixator in orthopedic ward PUMHSW Hospital Nawabshah. Study Design: Cross-Sectional Comparative study. Setting: Orthopedic Department, Peoples University of Medical And Health Science Shaheed Benazirabad. Period: 18 months from January 2017 to June 2018. Material & Methods: The data was analyzed in SPSS Version 22.0. Results: Out of 50 patients with tibial diaphyseal fractures, there were 34 males compared to females 16 (2.1:1) (68% vs 32%) with an average age of 41 years. Patients with external fixator applied yielded decreased rates of infection; shorter duration of hospital stay and early union compared to patients with plaster of Paris (pop) cast application. However, the difference reached statistical significant value. Conclusion: Open Tibial diaphyseal fractures should be managed with external fixation that yields better results. A plaster cast is the initial treatment of modality in patients with open tibial diaphyseal fractures.

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Kumar, B. S. Vijaya. "Treatment of diaphyseal fractures of tibia with intramedullary interlocking nail." International Journal of Research in Orthopaedics 5, no. 5 (August 26, 2019): 783. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20193130.

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Background: The tibia, or shinbone, is the most commonly fractured long bone in the body. A tibial shaft fracture occurs along the length of the bone, below the knee and above the ankle. It typically takes a major force to cause this type of broken leg. Motor vehicle collisions, for example, are a common cause of tibial shaft fractures. In many tibia fractures, the smaller bone in the lower leg (fibula) is broken as well. The objective was to study fracture healing and union rates with closed intra-medullary interlocking nailing.Methods: Patients of both sexes belonging to adult age group presenting with fracture tibia to Orthopedic Department, Vydehi Institute of Medical Sciences, of are admitted from January 2015 to December 2015.Results: In the present study maximum number of patients belongs to 18 to 27 years age group (18 cases) followed by 28 to 37 years age group (15 cases), maximum number of patients sustained tibia fracture due to RTA (38 cases) followed by fall (12 cases), maximum number of patients sustained simple tibia fracture (32 cases), followed by type 2 compound tibia fracture (13 cases) and 36 patients had excellent functional results and 8 patients had good functional outcome, while only 4 patients had fair functional outcome.Conclusions: IM rods are secured within the bone by screws both above and below the fracture. The metal screws and the rod can be removed if they cause problems, but can also be left in place for life. Tibial rodding provides excellent fixation and alignment of the bones.

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Grubor, Predrag, Milan Grubor, and Rade Tanjga. "Dilemmas in the treatment of tibial diaphyseal fractures." Acta chirurgica Iugoslavica 60, no. 2 (2013): 33–39. http://dx.doi.org/10.2298/aci1302033g.

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Introduction: Tibial fractures accompanied by radius fractures at typical sites are the most common type of fractures. Objective: The study is aimed at using the examined sample to make an efficient and economically acceptable choice in the treatment of tibial diaphyseal fractures. Material and methods: The series comprises a retrospective and prospective study of the treatment of 131 fresh tibial fractures: 31 in women (23.66%) and 100 in men (76.34%) of the average age of 37.89. Nineteen patients (14.50%) were treated conservatively and 112 (85.50%) surgically: 22 (16.79%) with anti-rotation intramedullary nails, 74 (56.49%) with Mitkovic external fixator type M20, and 16 (12.21%) with locking compression plate. General anaesthesia was used in 46 patients (35.11%), while spinal anaesthesia was used in 85 of them (64.89%). Results: According to the Karlstrom-Olerud scoring system, the treatment results were as follows: for the 22 tibiae treated with anti-rotation intramedullary nails: in 15(68.18%) the results were excellent, in 3 (13.64%) they were good and in 4(18.18%) they were poor. As for the results for the 74 tibiae treated with Mitkovic external fixator type M20, they were as follows: in 62(83.78%) excellent, in 9(12.16%) good, and in 3(4.05%) they were poor. The results for the 16 patients treated with locking compression plate were excellent in 10(62.50%), good in 2(12.50%) and poor in 4 patients (25.00%). The treatment results for the 19 tibiae treated with plaster cast were excellent in 12 patients (63.16%), good in 2(10.53%) and poor in 5 (26.32%). The definite results for the 131 fractured tibiae treated with the aforementioned techniques were as follows: excellent in 99(75.57%), good in 17 (12.98%) and poor in 15 patients (11.45%). Discussion: There is a variety of controversial positions concerning the treatment of the tibial diaphysis. Conclusion: On the basis of the results of surgical treatment for the given series, the number of surgical interventions, the price of osteosynthetic material, my preferences in treating tibial diaphyseal fractures would be as follows: Mitkovic external fixator type M20, anti-rotation intramedullary nails and locking compression plate. Conservative treatment is indicated when the X-ray examination confirms that the fragments have a position acceptable for conservative treatment with plaster cast.

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Singer, Ronald W., and James F. Kellam. "Open Tibial Diaphyseal Fractures." Clinical Orthopaedics and Related Research &NA;, no. 315 (June 1995): 114???118. http://dx.doi.org/10.1097/00003086-199506000-00012.

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Amin, Muhammad Qazi, Ashfaq Ahmed, Muhammad Imran, Naeem Ahmed, Shahzad Javed, and Amer Aziz. "TIBIAL SHAFT FRACTURES;." Professional Medical Journal 24, no. 01 (January 18, 2017): 75–81. http://dx.doi.org/10.29309/tpmj/2017.24.01.413.

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Background: Tibia is the most commonly fractured bone because of itsstructure and position. Tibial fractures are increasing with time to time and hence the morbidityand mortality are increasing despite proper public health efforts. There is a lack of nationalepidemiological data on the characteristics of patients with tibial shaft fractures. Therefore,epidemiological assessment is crucial for fracture. The purpose of this study was to provide upto-date information about patients baseline demographics, distribution of fracture classification,trauma mechanism and to formulate the preventive measures. Study Design: Retrospectivestudy. Setting: Emergency or OPD at Orthopaedics and Spine Centre, Ghurki Trust TeachingHospital, Lahore. Period: 1st January 2011 to 31st December 2015. Material and methods:Any type of diaphyseal tibial fracture. The data were taken from hospital database and includeclinical, epidemiological and radiological records. The results were analyzed using SPSS 20.Results: A total of 2120 patients were included in the study. 1980(93.4%) were male and 140(6.6%) were females. Male to females ratio were 14.14:1 with mean age of 33.28 ± 21.02.Between 0-20 years, 519(24.5%) of patients were admitted, 1021(48.2%) of patients werebetween 21-40 years, 467(22.0%) were between 41-60 years and only 113(5.33%) were above60 years. Type A2 in 444(20.9%) were the most common pattern of fracture found. The traumaswere most common in months of May, June and July and Motorbike accidents were the maincause. The mid shaft of tibia is the most commonly fractured i-e 1038 (49.0%) followed bydistal part i-e 611(28.8%) and the least is the proximal i-e 471(22.22%). Conclusion: Thisstudy shows AO-type 4A2 was the most common fracture type, representing 20.9% of all tibialshaft fractures. The individuals between 21-40 years were mostly affected and the motorbikeaccidents were found the main cause for such traumas.

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Islam, Md Ashraful, Md Abdur Rashid, Md Rafiqul Islam, Md Hafizur Rahman Milon, and Md Kaiser Mahmud. "Management of Fractures Shaft of Tibia in Adult Interlocking Nailing Versus Plating in: A Comparative Study." KYAMC Journal 10, no. 2 (August 26, 2019): 99–105. http://dx.doi.org/10.3329/kyamcj.v10i2.42788.

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Background: Tibial shaft fractures are the commonest long bone fractures in adults, most commonly managed by intramedullary interlocking nailing. However, several meta-analysis show that locking plate osteosynthesis is equally effective in managing tibial diaphyseal fractures and are associated with less number of complications. Aim: To compare the results of fixation of tibial fractures followingplating and nailing in terms of union, patient satisfaction and complications. Materials and Methods: Khwaja Yunus Ali Medical College and Hospital based non randomized clinical trial was performed from September 2014 to August 2017 where closed or open diaphyseal or metaphyseo- diaphyseal fractures of the tibia (closed or open Gustilo Anderson type 1 through 3B) were included. Simple sequential allocation was used for allotting the patients to two groups, one for interlocking nailing and other for plating. The patients were followed up for clinical, radiographic and functional results. Results: Forty patients with 41 involved limbs completed followup for one year. in our study was 19.55±0.69 weeks in case of interlocking nailing and 20.38±1.39 weeks in case of plating and there was no statistically significant difference between the two. Conclusion: There was no difference between the twomodalities in terms of fracture union. Complications were lesser but more serious in case of plating. Patient satisfaction was more with plating. KYAMC Journal Vol. 10, No.-2, July 2019, Page 99-105

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Haonga, Billy T., Mapuor M. M. Areu, Sravya T. Challa, Max B. Liu, Edmund Elieza, Saam Morshed, and David Shearer. "Early treatment of open diaphyseal tibia fracture with intramedullary nail versus external fixator in Tanzania: Cost effectiveness analysis using preliminary data from Muhimbili Orthopaedic Institute." SICOT-J 5 (2019): 20. http://dx.doi.org/10.1051/sicotj/2019022.

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Introduction: Open tibia fractures are some of the most common types of Orthopedics injuries in low- and middle-income countries (LMICs). In Tanzania, open tibia fractures are treated either conservatively by prolonged cast or surgically by external fixation (EF) or intramedullary nail (IMN) when available. The cost of treatment and amount of time patients spend away from work are major economic concerns with prolonged casting and EF. The goal of this study was to determine the cost effectiveness of IMN versus EF in the treatment of open diaphyseal tibia fractures at Muhimbili Orthopaedic Institute (Dar es Salaam, Tanzania). Methods: This is a prospective randomized control study conducted of patients with a closeable AO/OTA 42 open diaphyseal tibia fracture. The patients underwent surgical fixation with either IMN or EF at Muhimbili Orthopaedic Institute (MOI), and were followed up at 2, 6, and 12 weeks postoperatively. A micro-costing method was used to estimate the fixed and variable costs of IMN and EF of the open diaphyseal tibial fracture. Results: The mean total cost per patient was lower for the IMN group ($425.8 ± 38.4) compared to the EF group ($559.6 ± 70.5, p < 0.001), with savings of $133.80 per patient for the IMN group. The mean hospital stay was 2.72 ± 1.40 days for the IMN group and 2.44 ± 1.47 days for the EF group (p = 0.5). Quality-adjusted life years (QALYs) were 0.26 per patient for the IMN group and 0.24 in the EF group at 12 weeks (p = 0.8). Ninety-two percent of patients in the IMN group achieved fracture union versus 60% in the EF group at three months postoperatively (p = 0.03). Conclusion: IM nailing of a closeable open diaphyseal tibial fracture is more cost effective than EF. In addition, IM nailing has better union rates at three months compared to EF.

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Acharya, Balakrishnan M., Rojan Tamrakar, Pramod Devkota, Abhishek K. Thakur, and Suman K. Shrestha. "Outcome of tibial diaphyseal fracture fixation with Surgical Implant Generation Network (SIGN) nail." Journal of Patan Academy of Health Sciences 6, no. 2 (December 31, 2019): 5–11. http://dx.doi.org/10.3126/jpahs.v6i2.27206.

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Introductions: Fractures of diaphyseal region of the tibial bone are amongst the most commonly seen extremity injuries in the developing countries. The surgical implant generation network (SIGN) intramedullary (IM) nail was designed for the treatment of long bone fractures in the developing nations. Methods: From March 2008 to December 2018, a total of 104 patients with 104 tibial diaphyseal fractures were treated with SIGN IM nail. The follow-up visits were arranged at 6, 12, 24 weeks and one-year post operatively. During follow-up visits, the signs of fracture union clinically as well as radiologically and the presence of complications any were recorded and analyzed. Results: The mean age of the patients was 32.81 (16 – 65) years, male 74 (71.2%) and female 30 (28.8%). Majority of the patients 70 (67.3%) had fractures after road traffic accidents. The mean time of surgery was 13.58 (1 – 463) days. Six (5.8%) patients had delayed union and no non-union was detected. We had 10 cases (9.6%) of mal-alignment but were on acceptable range. Conclusions: In the developing country like Nepal, the SIGN nail is an effective surgical implant for the management of the tibial diaphyseal fractures with good result of fracture union and low rates of nonunion, mal-alignment and manageable complications.

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Makaram, Navnit S., Jun Min Leow, Nicholas D. Clement, William M. Oliver, Zhan H. Ng, Cameron Simpson, and John F. Keating. "Risk factors associated with delayed and aseptic nonunion following tibial diaphyseal fractures managed with intramedullary nailing." Bone & Joint Open 2, no. 4 (April 1, 2021): 227–35. http://dx.doi.org/10.1302/2633-1462.24.bjo-2021-0012.r1.

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Aims The primary aim of this study was to identify independent predictors associated with nonunion and delayed union of tibial diaphyseal fractures treated with intramedullary nailing. The secondary aim was to assess the Radiological Union Scale for Tibial fractures (RUST) score as an early predictor of tibial fracture nonunion. Methods A consecutive series of 647 patients who underwent intramedullary nailing for tibial diaphyseal fractures were identified from a trauma database. Demographic data, comorbidities, smoking status, alcohol consumption, use of non-steroidal anti-inflammatory drugs (NSAIDs), and steroid use were documented. Details regarding mechanism of injury, fracture classification, complications, and further surgery were recorded. Nonunion was defined as the requirement for revision surgery to achieve union. Delayed union was defined as a RUST score < 10 at six months postoperatively. Results There were 41 nonunions (6.3%), of which 13 were infected (31.7%), and 77 delayed unions (11.9%). There were 127 open fractures (19.6%). Adjusting for confounding variables, NSAID use (odds ratio (OR) 3.50; p = 0.042), superficial infection (OR 3.00; p = 0.026), open fractures (OR 5.44; p < 0.001), and high-energy mechanism (OR 2.51; p = 0.040) were independently associated with nonunion. Smoking (OR 1.76; p = 0.034), open fracture (OR 2.82; p = 0.001), and high-energy mechanism (OR 1.81; p = 0.030) were independent predictors associated with delayed union. The RUST score at six-week follow-up was highly predictive of nonunion (sensitivity and specificity of 75%). Conclusion NSAID use, high-energy mechanisms, open fractures, and superficial infection were independently associated with nonunion in patients with tibial diaphyseal fractures treated with intramedullary nailing. The six-week RUST score may be useful in identifying patients at risk of nonunion. Cite this article: Bone Jt Open 2021;2(4):227–235.

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Ferrandez, L., J. Curto, J. Sanchez, J. Guirall, and L. Ramos. "Orthopaedic treatment in tibial diaphyseal fractures." Archives of Orthopaedic and Trauma Surgery 111, no. 1 (December 1991): 53–57. http://dx.doi.org/10.1007/bf00390196.

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Hottmann, Natasha M., Matthew D. Johnson, Scott A. Banks, David Tuyn, and Daniel D. Lewis. "Biomechanical Comparison of Two Locking Plate Constructs for the Stabilization of Feline Tibial Fractures." Veterinary and Comparative Orthopaedics and Traumatology 33, no. 02 (December 13, 2019): 089–95. http://dx.doi.org/10.1055/s-0039-3399572.

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Abstract Objectives The aim of this study was to compare the biomechanical characteristics of locking compression plate (LCP) and conical coupling plate (CCP) constructs for the stabilization of experimentally induced gap fractures in cat tibiae. Materials and Methods Pelvic limbs were harvested from eight cat cadavers. Paired tibiae were stripped of all soft tissues, and randomly assigned to the LCP or CCP stabilization group. An eight-hole 2.7 mm LCP or a six-hole 2.5 mm CCP was applied to the medial surface of each tibia. A 1-cm segment of the tibia was excised centrally beneath the plate. The specimens were potted, then tested in non-destructive four-point craniocaudal and mediolateral bending, followed by non-destructive axial compression. Each construct was subsequently loaded to failure in axial compression. Bending and axial stiffness, yield load and failure load were calculated for each specimen. Results The LCP constructs were significantly stiffer than the CCP constructs when subjected to non-destructive bending and axial loading. Craniocaudal bending stiffness was significantly greater than mediolateral bending stiffness for both constructs. Yield load and failure load were significantly greater for LCP constructs compared with CCP constructs. Clinical Significance LCP may be a more suitable implant for stabilizing complex diaphyseal tibial fractures in cats. Additional supplemental fixation should be considered when using CCP to stabilize unreconstructed diaphyseal tibial fractures in cats. Further clinical investigation of both implants is recommended.

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Lewis, Daniel D., Stanley E. Kim, Justin Shmalberg, and Sandra L. MacArthur. "Correction of Excessive Tibial Plateau Angle and Limb Shortening in a Juvenile Dog Using a Hinged Circular Fixator Construct and Distraction Osteogenesis." Case Reports in Veterinary Medicine 2019 (November 16, 2019): 1–9. http://dx.doi.org/10.1155/2019/1439237.

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An 18-week-old Rhodesian Ridgeback puppy that was hit by a car sustained a Salter-Harris type III fracture of the left proximal tibial physis and ipsilateral diaphyseal femoral and tibial fractures. The diaphyseal fractures were successfully stabilized with bone plate fixation. Premature closure of the caudal aspect of the proximal tibial physis, secondary to the proximal physeal fracture, resulted in an excessively high tibial plateau angle (TPA) of 50° with a limb length discrepancy of 13% by 24 weeks of age. The deformity was addressed by performing a proximal tibial osteotomy and subsequent distraction osteogenesis to reduce the TPA while concurrently lengthening the crus. A radial osteotomy was performed in the proximal metaphyseal region and the hinged fixator was applied. Distraction was initiated the day following surgery at a rate of 1 mm per day as measured along the caudal cortex of the tibia with a rhythm of three distractions daily. Distraction was terminated 19 days postoperatively. Sequential distraction of the osteotomy resulted in 17 mm of tibial lengthening and a final TPA of 3°. The fixator was removed 52 days after application. Complications included wire tract inflammation involving the wires securing the proximal segment and a calcaneal fracture which required bone plate stabilization. The left pelvic limb was only 8% shorter than the right pelvic limb and the dog had only a subtle lameness 12 months after surgery. The hinged circular fixator construct allowed for both the reduction of the TPA and limb segment lengthening in this dog.

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Craig, Andrew, Philip G. Witte, Tristram Moody, Karen Harris, and Harry W. Scott. "Management of feline tibial diaphyseal fractures using orthogonal plates performed via minimally invasive plate osteosynthesis." Journal of Feline Medicine and Surgery 20, no. 1 (February 1, 2017): 6–14. http://dx.doi.org/10.1177/1098612x17692470.

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Objectives The objective was to assess the medium- and long-term outcomes (radiographic and owner questionnaire) of feline tibial diaphyseal fractures with orthogonal plate fixation via a minimally invasive plate osteosynthesis (MIPO) approach. Methods Medical records and radiographs of cats that had tibial diaphyseal fractures stabilised with orthogonal plates were obtained (2012–2016). Immediate postoperative radiographs were reviewed to assess the construct configuration and follow-up radiographs (where available) were used to assess bone healing and implant-related complications. An owner-completed questionnaire (feline musculoskeletal pain index [FMPI]) was used at a minimum of 6 months following surgery to assess the cats’ ability to perform normal activities. Results Eight feline tibial diaphyseal fractures met the inclusion criteria. One major complication was observed, most likely due to an operative technical error. There were no further complications following revision surgery. Six of the eight cases that had radiographic follow-up either had clinical bone union or showed evidence of bone healing. All cases were classified as successful according to FMPI. Conclusions and relevance Orthogonal plating of feline tibial diaphyseal fractures via an MIPO approach resulted in successful outcomes and a lower complication rate compared with previously reported techniques.

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Eken, Gokay, Cenk Ermutlu, Kemal Durak, Teoman Atici, Bartu Sarisozen, and Adnan Cakar. "Minimally invasive plate osteosynthesis for short oblique diaphyseal tibia fractures: does fracture site affect the outcomes?" Journal of International Medical Research 48, no. 10 (October 2020): 030006052096540. http://dx.doi.org/10.1177/0300060520965402.

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Objective To report the results of patients with short oblique diaphyseal tibia fractures treated with minimally invasive plate osteosynthesis (MIPO). The secondary aim was to understand the effect of fracture location (midshaft or distal 1/3) on outcomes. Methods Twenty-eight patients with short oblique (>30°) tibial shaft fractures (AO/OTA 42A2) treated with plate and MIPO technique between 2015 and 2019 were retrospectively assessed. Age, gender, follow-up time, fracture type (open or closed), operation time, postoperative infection rate, union time, ankle joint range of motion, and complications were analyzed. Patients’ radiographs at a minimum 1-year follow-up were evaluated for malunion, nonunion, and implant-related complications. Results Mean age and follow-up time were 47.0 ± 15.7 years and 18.3 ± 12.1 months, respectively. Mean bone union time was 3.66 ± 1.04 months in middle 1/3 diaphysis and 4.23 ± 1.48 months in distal 1/3 tibia fractures. Seven (25%) patients developed superficial infections. Mean union time, malunion rate, coronal and sagittal angulation, operation length, and infection rate were similar between the groups. Conclusion MIPO is an effective method for treatment of short oblique diaphyseal tibia fractures, and results in few complications. Both distal and midshaft fractures have similar union and malunion rates.

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Sandeep, A., and Jayant Jain. "Clinical and radiological evaluation of minimally invasive intramedullary fixation by titanium elastic nails in paediatric long bone fractures of lower limb: a prospective study." International Journal of Research in Orthopaedics 5, no. 5 (August 26, 2019): 816. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20193592.

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Background: Elastic stable intramedullary nailing for the treatment of paediatric femur and tibial diaphyseal fractures was introduced by Prevot and colleagues in 1979. It follows three-point fixation principle that provides internal support in presence of cortical contact and an intact soft-tissue envelope. This technique has many advantages, including better reduction, dynamic axial stabilization, shorter hospitalization with early rehabilitation and low complication rate.Methods: This is a prospective observational study done at Kauvery Medical Centre, Trichy between May 2017 to May 2018 consisting of 39 children between age 5 to 16 years with diaphyseal fractures of femur and tibia. The fractures were treated by closed reduction and internal fixation with titanium elastic intramedullary nailing. The patients were evaluated clinically and radiologically and followed for an average of 6 months. Outcome was assessed using transcutaneous electrical nerve stimulation (TENS) scoring system used by Flynn et al.Results: Our series consisted of 39 patients (22 cases with fracture shaft of femur and 17 cases with fracture shaft of tibia), 33 males and only 6 females. Average time for radiological union was 9.89 weeks. All patients had full range of hip and ankle motion and 2 (5.1%) patients had mild restriction in knee flexion at 12 weeks.Conclusions: Elastic stable intramedullary nailing is an ideal method for treatment of paediatric femoral and tibial diaphyseal fractures due to lower complication rate and good functional outcome in comparison to other methods of treatment.

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Valdés Santurio, E. R., V. Vallina García, and V. Álvarez Ortiz. "Physiopathology and Treatment of Tibial Diaphyseal Fractures." Revista Española de Cirugía Ortopédica y Traumatología (English Edition) 52, no. 1 (January 2008): 47–63. http://dx.doi.org/10.1016/s1988-8856(08)70068-3.

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McQueen, M. M., J. Christie, and C. M. Court-Brown. "ACUTE COMPARTMENT SYNDROME IN TIBIAL DIAPHYSEAL FRACTURES." Journal of Bone and Joint Surgery. British volume 78-B, no. 1 (January 1996): 95–98. http://dx.doi.org/10.1302/0301-620x.78b1.0780095.

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ROBERTS, S., and P. THOMAS. "ACUTE COMPARTMENT SYNDROME IN TIBIAL DIAPHYSEAL FRACTURES." Journal of Bone and Joint Surgery. British volume 78-B, no. 4 (July 1996): 683. http://dx.doi.org/10.1302/0301-620x.78b4.0780683a.

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Court-Brown, Charles M., and Alistair Brydone. "Social deprivation and adult tibial diaphyseal fractures." Injury 38, no. 7 (July 2007): 750–54. http://dx.doi.org/10.1016/j.injury.2006.12.008.

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Pinnaka, Balakrishna, Shankarlinga S., K. Ramachandra Kamath, Rajashekar Danda, and M. Girish Raju. "A comparative study of low multidirectional locked nailing and locking compression plating in management of distal tibia fractures." International Journal of Research in Orthopaedics 4, no. 6 (October 24, 2018): 830. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20184246.

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Background: Ideal management for distal tibial meta-diaphyseal fracture remains controversial, due to lack of adequate evidences about implants and multiple treatment modalities. Most commonly these fractures were dealt with either locking compression plate (LCP) or by multi directional intra-medullary nail (IMIL). Aim is to compare these two implants, to understand the mechanism and find out the ideal implant for the management of distal tibia fractures.Methods: This study is prospective and comparative done at the associated hospitals of KMC Mangalore, spanning a period of around 2 years (October 2014 to July 2016). All patients presented with distal tibial meta-diaphyseal fractures were included in the study. Patients were treated with either low multi directional IMIL nail or by LCP and followed up for a minimum period of 6 months. Outcome measures included Olerud Molander Ankle Score (OMAS), wound issues, union of the fracture and patient mobility.Results: 50 consecutive patients (mean age 40 years) were included in the study, divided equally into 2 groups. Group-A treated with multi directional IMIL nail and group-B with MIPPO plating. Mean functional OMAS score for nailing is 91 and for plating is 88. All fractures treated with nailing united within 6 months and 4% patient treated by plating goes mal union and 4% infected.Conclusions: For distal tibial fracture management, intra-medullary nailing proved reliable surgical option with regards to the OMAS score, fracture union and less infection rates.

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Umrani, Khawand Bukhsh, Zamir Hussain Tunio, Mohammad Aslam Mengal, Abdul Hafeez Qureshi, Parvez Ahmed, and Naimatullah Kalhoro. "Comparative study on intramedullary nailing versus AO external fixation in the management of gustilo type II, IIIA, and IIIB tibial shaft fractures." Professional Medical Journal 27, no. 06 (June 10, 2020): 1199–205. http://dx.doi.org/10.29309/tpmj/2020.27.06.4096.

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Objectives: To compare the external fixator and unreamed interlocking nail in treating Gustilo type II, type IIIA, and type IIIB tibial diaphyseal fractures regarding complications. Study Design: Cross-Sectional and Comparative Study. Setting: Department of Orthopaedic Surgery and Traumatology (DOST) Liaquat University of Medical and Health Sciences Jamshoro/Hyderabad. Period: Two years February 2016 to January 2018. Material & Methods: 40 cases of open tibia fractures in Patients of Gustilo type II, type IIIA, and type IIIB tibial diaphyseal fractures were included. The data were analyzed using the statistical program SPSS version 16.0. Results: A total of 23 cases were treated by external fixator and 22 cases were treated by unreamed solid interlocking nail. A total of 14 cases, that is, 31% showed delayed union. Type II injury 3/15 = 20%; Type IIIA injury 6/22 = 27.3%; Type IIIB injury it is -5/8 = 12.5%. For cases treated with unreamed nail, it was 22.7%; external fixator was 39.1% among 45 cases, 05 cases showed nonunion. For cases treated with unreamed nail, it was 13.6%; external fixation was 8.7%. The overall rate of eep infection is 11.1%. The rate in interlocking nail was 13.6%, and external fixation was 8.7%. Reoperation in the form of dynamization and bone graft application after 20 weeks in unreamed nail was 36.4%, whereas in external fixation the rate was high, almost 48%. The average time of union with unreamed interlocking was about 25.4 weeks, wherein external fixation it was 28.6 weeks. Conclusion: External fixators are a good and reliable method of stabilization of Gustilo type II, type IIIA, and type IIIB tibial diaphyseal fractures, unreamed interlocking intramedullary nail yields better results in treating Gustilo type II and type IIIA tibial shaft fractures.

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Sarmiento, Augusto, Harry A. McKellop, Adolfo Llinas, Sang-Hyun Park, Bin Lu, William Stetson, and Raj Rao. "Effect of loading and fracture motions on diaphyseal tibial fractures." Journal of Orthopaedic Research 14, no. 1 (January 1996): 80–84. http://dx.doi.org/10.1002/jor.1100140114.

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Sperone, Enzo, Matias Iglesias, Andrés Bigatti, Iván Torterola, Yanser Atilmis, and Alberto Macklin Vadell. "Suprapatellar intramedullary nailing of the tibia." Journal of the Foot & Ankle 14, no. 2 (August 30, 2020): 153–57. http://dx.doi.org/10.30795/jfootankle.2020.v14.1175.

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Objective: To report our experience with intramedullary fixation and osteosynthesis of the tibia with suprapatellar approach and semiextended positioning. Methods: This study retrospectively assessed 6 patients with tibial fracture treated with suprapatellar intramedullary nail fixation and osteosynthesis from September 2015 to September 2018. Results: There was acceptable bone fixation. Mean healing time was 6 months (range: 4-10 months). Postoperative pain was assessed using a visual analog scale, and the knee was divided into 9 quadrants to help locate the specific site of pain; all participants reported that pain was located at distal quadrants. Knee function was completely restored. Conclusion: Suprapatellar approach with the knee in the semiextended position is a good surgical technique for extra-articular proximal tibial fractures or those associated with soft tissue involvement at the conventional infrapatellar entry site. Thus, this analysis led us to believe that the technique should also be applicable to middle diaphyseal fractures or fractures in general, regardless of their location. Level of Evidence IV, Therapeutic Studies; Case Series.

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Pizzolo, Samuele, Gianluca Testa, Giacomo Papotto, Giuseppe Mobilia, Giovanni Di Stefano, Giuseppe Sessa, and Vito Pavone. "Open Tibial Fracture in a Non-Compliant Patient: A Case Report." Journal of Functional Morphology and Kinesiology 3, no. 3 (August 11, 2018): 44. http://dx.doi.org/10.3390/jfmk3030044.

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Open tibial fractures represent the most frequent fractures of long bones, comprising approximately 1.9% of all fractures. Although locked intramedullary nailing is the gold standard for treating closed and unstable tibia diaphyseal fractures, for most exposed fractures, an external fixator can first be used, followed by conversion through an intramedullary nail. The present report describes the case of a 17-year-old male who presented with a complex multi-segmented displaced tibia fracture, type 42-C3, with exposure of IIIB type according to the Gustilo–Anderson classification, and with an attached disrupted fracture of peroneal malleolus, type 44-B2. External fixation was the preferred treatment method. Before the definitive surgical treatment, the patient had a second accident that caused refracture and damage to the soft tissues and external fixation system. This prolonged the time estimated for the conversion from the external fixator to the intramedullary nail. The reported case shows the use of various treatment steps with different timelines and an intervention with vacuum-assisted closure therapy for soft tissue healing as well as subsequent intramedullary nailing in order to reach the definitive healing of a non-compliant patient. These combined methods achieved an acceptable reduction and good stability of such a complex fracture.

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MOHITE, DR NINAD, Dr Harshad P. Maheshwari, and Dr Nikhil A. Garg. "Short Term Result of Closed Intra Medullary Fixation of Tibial Diaphyseal Fractures." International Journal of Scientific Research 3, no. 2 (June 1, 2012): 320–22. http://dx.doi.org/10.15373/22778179/feb2014/101.

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Meige, F., A. Autefage, and S. Sarrau. "Treatment of femoral and tibial fractures in puppies by elastic plate osteosynthesis." Veterinary and Comparative Orthopaedics and Traumatology 20, no. 01 (2007): 51–58. http://dx.doi.org/10.1055/s-0037-1616588.

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SummarySeventeen puppies, two to four months old, with a femoral (n=12) or tibial (n=5) diaphyseal fracture were treated by elastic plate osteosynthesis with a Veterinary Cuttable Plate (VCP) or straight plate. In one case of femoral fracture treated with a VCP, plate bending due to an excessive elasticity of the implant was observed three days after the osteosynthesis and surgical revision was required. Two cases of femoral overgrowth and one case of slight femoral head and neck retroversion were identified during the radiographic follow-up but without any clinical consequences. Bone healing was obtained for all fractures four to eight weeks (5.64±0.88 weeks) after the surgical procedure, and functional results were excellent in all cases. Our study confirms that elastic plate osteosynthesis with either a VCP or straight plate can be used to treat femoral diaphyseal fractures in medium and large breed puppies less than four months old, but that modification of implant elasticity or rigid osteosynthesis use is required when such puppies reach four months. The same technique can also be used successfully to treat tibial fractures in puppies younger than four months old.

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Hasan, Md Habibul, Mohd Alamgir Hossain, Md Enamul Haque, Md Ahsanuzaman, Elora Parveen, and Abul Kalam Azad. "Evaluation of Results of Closed Reamed Nailing for Diaphyseal Fracture of the Tibia-Experience of 35 cases." TAJ: Journal of Teachers Association 32, no. 1 (August 20, 2019): 9–16. http://dx.doi.org/10.3329/taj.v32i1.42683.

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Introduction: Tibia is a subcutaneous bone and is more prone to trauma. Different treatment modalities exist for fracture shaft of the tibia. Intramedullary nailing in the treatment of fractures of the long bones was technically developed and popularized by Küntscher in the 1940’s. Treatment of tibial fracture in adult is a challenge to orthopedic surgeons due to poor soft tissue coverage and blood supply. Materials and methods: This study was prospective and interventional. This study was carried out in the private hospitals in Rajshahi over a period of 3 years. Total 35 patients with tibial shaft fracture were studied. Inclusion criteria were displaced closed diaphyseal fracture shaft of the Tibia, open fracture with Gustillo 1, 2 and 3A attended within 24 hours. Exclusion criteria were patient’s age below 16 years, grossly lacerated fracture, undisplaced fracture, patient unwilling to operate. Thirty three cases were operated within one week only two cases operated at 2 months due to angulations following conservative treatment. Open fracture was fixed within 24-48 hours. Broad spectrum antibiotic injectable Moxifloxacin was used in most of the cases for 2 doses then oral, Injectable Meropenem was used for the open fracture. Those patients suffering from G-3A fracture wound were covered by Hemisoleal flap Two weeks after primary surgery and were uneventful. In most of the cases image intensification was not used only three cases needed image intensification in case the fractures in lower ¼ th of the shaft to see the end of the Nail. Results: Two patients developed postoperative superficial wound infection which was recovered by regular dressing. Only one patient needed post-operative cast support because the fracture was comminuted. All patients started Knee bending from first post-operative day. Full range of knee movement was found in all patients. All fracture united properly within 12 weeks to 22 weeks with mean of 17 weeks. No cases of implant failure detected during the study period. Conclusion: The results of the current study reveal that the reamed interlocking nail in treatment of tibial diaphyseal fracture is safe, easy, successful and preferable method may be recommended as a stable fixation with early return to daily activities. TAJ 2019; 32(1): 9-16

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Hussain Mirjat, Ashfaque, Irshad Ahmed Bhutto, and Shakeel Ahmed Memon. "AO EXTERNAL FIXATOR." Professional Medical Journal 23, no. 03 (March 10, 2016): 279–83. http://dx.doi.org/10.29309/tpmj/2016.23.03.1473.

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Objectives: To appraise effectiveness of AO external fixator, a treatment methodfor open diaphseal tibial fractures (type II, IIIA). Methods: Study Design: Cross sectional study.Setting: Department of Orthopedic Surgery and Traumatology (DOST) Liaquat University ofMedical & Health Sciences Jamshoro. Period: Two year from 2009 to 2011. Total 40 cases ofopen tibia fracture had selected all the cases with fresh open diaphyseal fractures of tibia andpatient arriving within one week injury. And Grade II, IIIA had included. All the cases associatedwith head injury or abdominal injury, diabetic mellitus and liver or kidney disease had excluded.Results: Total 40 cases of open diaphyseal fracture of tibia were selected in this study basedon inclusion criteria. The mean age was 33.1 + 10.27 years. Out of 40 cases, 36(90.0%) weremale. Majority of patients of RTA were injured due to motorcycle accidents 24(60.0%). Mean ofunion time was 18.1 + 3.72 weeks. Wound became infected in 5(12.5%) cases, 5.0%, n = 40)were seen with late union, screw sites infection found in 5.0% cases, Knee stiffness was foundin 10.0% cases, six 15.0% patients developed pain during walking. Conclusion: AO fixationis very safe, insignificant intrusive, get short surgical time, following by hospital duration, lowinfection rate and can be utilized as unequivocal and effective administration of open tibialfractures.

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Rochat, M., J. Ritchey, M. Payton, and D. Dugat. "Quantitative analysis of the intramedullary arterial supply of the feline tibia." Veterinary and Comparative Orthopaedics and Traumatology 24, no. 05 (2011): 313–19. http://dx.doi.org/10.3415/vcot-11-02-0025.

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SummaryObjectives: To quantitatively describe the intramedullary arterial supply of the adult feline tibia and determine if the arterial supply is significantly different from that of adult small dogs.Methods: Cadaveric feline and canine pelvic limbs were obtained to prospectively investigate the intramedullary arterial supply of the tibia. A microvascular injection and modified Spalteholz bone clearing technique were used to characterize and quantify the intramedullary arterial supply of the tibia. Statistical comparisons were made between cats and dogs for the percentage of intramedullary arterial supply (arterial density) and the diameter of the nutrient artery.Results: No significant difference was observed in the intramedullary arterial density between dog and cat tibiae. The feline nutrient artery diameter (0.55 ± 0.1 mm) was significantly greater than the canine nutrient artery (0.30 ± 0.04 mm) in the distal section of bone. Dogs subjectively had a greater number of branching vessels in the distal and mid-diaphyseal sections of bone when compared to cats.Clinical significance: Delayed fracture healing in the feline tibia does not appear to be associated with a lack of intramedullary arterial supply. A lack of diffuse arborization of the arterial supply to the middle and distal feline tibia may explain, at least in part, why feline tibial delayed or nonunions may be more common than in canine tibial fractures.

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Hurter, K., P. Schawalder, and H. G. Schmökel. "Percutaneous plating of tibial fractures in two dogs." Veterinary and Comparative Orthopaedics and Traumatology 16, no. 03 (July 2003): 191–95. http://dx.doi.org/10.1055/s-0038-1632776.

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SummaryA trend toward minimally invasive procedures in the treatment of fractures in human patients is apparent in recent publications. Percutaneous plating is one method of fracture fixation, conceived to minimise soft tissue damage and preserve soft tissue and bone vascularity. The use of fewer screws, in longer bridging plates, is also a relatively new technique in the stabilisation of comminuted diaphyseal fractures in human patients. A combination of these techniques was applied in two dogs with comminuted tibial fractures.The plates were passed subfascially and the screws inserted through skin incisions over the proximal and distal ends of the plate. Follow-up radiographs revealed fracture healing with callus formation after four or five weeks. Percutaneous plating seems to be a useful technique in small animals. Further studies on larger numbers of patients are needed to define the benefits and the limitations of this technique.

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Townley, WA, DQA Nguyen, JC Rooker, JK Dickson, DZ Goroszeniuk, MS Khan, and D. Camp. "Management of open tibial fractures – a regional experience." Annals of The Royal College of Surgeons of England 92, no. 8 (November 2010): 693–96. http://dx.doi.org/10.1308/003588410x12699663904592.

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INTRODUCTION The treatment of soft-tissue injuries associated with tibial diaphyseal fractures presents a clinical challenge that is best managed by a combined plastic and orthopaedic surgery approach. The current study was undertaken to assess early treatment outcomes and burden of service provision across five regional plastic surgery units in the South-West of England. SUBJECTS AND METHODS We conducted a prospective 6-month audit of open tibial diaphyseal fracture management in five plastic surgery units (Bristol, Exeter, Plymouth, Salisbury, Swansea) with a collective catchment of 9.2 million people. Detailed data were collected on patient demographics, injury pattern, surgical management and outcome followed to discharge. RESULTS The study group consisted of 55 patients (40 male, 15 female). Twenty-two patients presented directly to the emergency department at the specialist hospital (primary group), 33 patients were initially managed at a local hospital (tertiary group). The mean time from injury to soft tissue cover was significantly less (P < 0.001) in the primary group (3.6 ± 0.8 days) than the tertiary group (10.8 ± 2.2 days), principally due to a delay in referral in the latter group (5.4 ±1.7 days). Cover was achieved with 39 flaps (19 free, 20 local), eight split skin grafts. Nine wounds closed directly or by secondary intention. There were 11 early complications (20%) including one flap failure and four infections. The overall mean length of stay was 17.5 ± 2.8 days. CONCLUSIONS Multidisciplinary management of severe open tibial diaphyseal may not be feasible at presentation of injury depending on local hospital specialist services available. Our results highlight the need for robust assessment, triage and senior orthopaedic review in the early post-injury phase. However, broader improvements in the management of lower limb trauma will additionally require further development of combined specialist trauma centres.

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Council, Nicola, Jon Dyce, Wm Tod Drost, Joao Felipe de Brito Galvao, Thomas J. Rosol, and Dennis J. Chew. "Bilateral patellar fractures and increased cortical bone thickness associated with long-term oral alendronate treatment in a cat." Journal of Feline Medicine and Surgery Open Reports 3, no. 2 (July 2017): 205511691772713. http://dx.doi.org/10.1177/2055116917727137.

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Case summary A 14-year-old cat presented with bilateral patellar fractures and radiographically thickened tibial cortices. This cat had been treated with alendronate for 8 years prior to presentation. To remove the subjectivity of the radiographic evaluation, tibial radiographs from 35 apparently healthy geriatric cats were used for comparison. Cortical and diaphyseal thickness were measured at the proximal and distal thirds of the tibia. Our cat had increased cortical bone thickness compared to that of the control cats. Relevance and novel information Treatment with bisphosphonates can lead to brittle bones and fractures after prolonged use in humans. This is the first description of fractures and cortical bone changes that may have been associated with prolonged bisphosphonate use in a cat. Radiographic measurements of cortical bone thickness may identify cats that are at increased risk for bone pathology secondary to prolonged alendronate use.

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Gupta, AnilKumar, KailashPrasad Srivastava, and Sachin Avasthi. "Pulsed electromagnetic stimulation in nonunion of tibial diaphyseal fractures." Indian Journal of Orthopaedics 43, no. 2 (2009): 156. http://dx.doi.org/10.4103/0019-5413.50850.

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Herman, Martin J., Melissa A. Martinek, and Joshua M. Abzug. "Complications of Tibial Eminence and Diaphyseal Fractures in Children." Journal of the American Academy of Orthopaedic Surgeons 22, no. 11 (November 2014): 730–41. http://dx.doi.org/10.5435/jaaos-22-11-730.

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KAUSHAL, MOHINDER, MS CHHABRA, and RC SEN. "MANAGEMENT OF UNSTABLE TIBIAL DIAPHYSEAL FRACTURES BY EXTERNAL FIXATION." Medical Journal Armed Forces India 54, no. 4 (October 1998): 319–21. http://dx.doi.org/10.1016/s0377-1237(17)30594-4.

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Shaw, A. D., T. Gustilo, and C. M. Court-Brown. "Epidemiology and outcome of tibial diaphyseal fractures in footballers." Injury 28, no. 5-6 (June 1997): 365–67. http://dx.doi.org/10.1016/s0020-1383(97)00021-1.

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Clement, N. D., N. J. F. Beauchamp, A. D. Duckworth, M. M. McQueen, and C. M. Court-Brown. "The outcome of tibial diaphyseal fractures in the elderly." Bone & Joint Journal 95-B, no. 9 (September 2013): 1255–62. http://dx.doi.org/10.1302/0301-620x.95b9.31112.

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Lee, Young Goo, Jnng Seok Choi, Young Chang Kim, Hyun Duck Yoo, Seung Seok Seo, and Sang Hun Ha. "Treatment using Intramedullary Fixation for Open Tibial Diaphyseal Fractures." Journal of the Korean Society of Fractures 9, no. 3 (1996): 583. http://dx.doi.org/10.12671/jksf.1996.9.3.583.

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Navascués, J. A., J. L. González-López, S. López-Valverde, J. Soleto, J. A. Rodriguez-Durantez, and J. L. García-Trevijano. "Premature Physeal Closure After Tibial Diaphyseal Fractures in Adolescents." Journal of Pediatric Orthopaedics 20, no. 2 (March 2000): 193–96. http://dx.doi.org/10.1097/01241398-200003000-00012.

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Bozkurt, Celal, and Baran Sarikaya. "A Surgical Opinion in a 36-Week Pregnant with Tibia Fracture: Intramedullary Nailing." Case Reports in Orthopedics 2016 (2016): 1–4. http://dx.doi.org/10.1155/2016/1454835.

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The operative treatment of tibial fractures in late pregnancy is a controversial issue that is rarely discussed in the literature. Here we present a case of a tibial diaphyseal fracture in a woman that was 36 weeks pregnant, which was treated with intramedullary nails under noninvasive foetal monitoring with cardiotocography. The patient underwent a successful surgery, and no harm or adverse events to either the mother or the foetus were reported during or after the procedure. Following surgery, the mother had a comfortable pregnancy and a normal spontaneous vaginal delivery with a healthy newborn.

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Nanai, Beatrix, and Randy R. Basinger. "Use of a New Investigational Interlocking Nail Supplement in the Repair of Comminuted Diaphyseal Tibia Fractures in Two Dogs." Journal of the American Animal Hospital Association 41, no. 3 (May 1, 2005): 203–8. http://dx.doi.org/10.5326/0410203.

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Two dogs were diagnosed with highly comminuted diaphyseal tibial fractures following traumatic incidents. Investigational hybrid interlocking nail (ILN) bolt/external skeletal fixator (ESF) pins were used to repair both fractures. The surgery was successful, and fractures healed without complications by 6 weeks (case no. 1) and 17 weeks (case no. 2) after surgery. This article describes the application and the advantages of a new, investigational ILN supplement that was specifically designed to accomplish initial rigid stability and allow progressive destabilization to the fracture repair. The authors are continuing to study the biomechanical properties of this procedure in order to accurately establish clear recommendations for its use in certain fracture situations.

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Court-Brown, C. M., and S. P. F. Hughes. "Hughes External Fixator in Treatment of Tibial Fractures." Journal of the Royal Society of Medicine 78, no. 10 (October 1985): 830–37. http://dx.doi.org/10.1177/014107688507801008.

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The results of a prospective trial of the use of the Hughes unilateral external fixator in the management of 48 tibial diaphyseal fractures are presented. Good results were obtained in grade II and III fractures but not in closed and grade I fractures. The results and complication rates were comparable with those of other more complex external fixators. Good results were found to be dependent on the adequacy of the initial reduction and the duration of external fixation, but independent of alterations in pin angle, length and location as well as fixator location.

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Kamruzzaman, AHSM, and S. Islam. "Result of closed interlocking intramedullary nail in tibial shaft fracture." Bangladesh Medical Journal Khulna 44, no. 1-2 (April 23, 2012): 15–17. http://dx.doi.org/10.3329/bmjk.v44i1-2.10470.

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The management of tibial diaphyseal fractures has always held a particular interest for orthopedic surgeons. Not only they are relatively common but also they are often difficult to treat. This prospective study was carried out at Rangpur from April 2008 to November 2009. 34 patients were treated by closed interlocking intramedullary nail. Goal of this study was to find out a safe & effective management of fracture, early mobility of patient, functional joint motion and short stay in hospital. Routine follow up was carried out in 29 patients. In 24 cases, fracture (81.76%) were united, 4 cases (13.79%) needed dynamisation with autogenous bone grafting and 1 case devoloped non union. Study showed interlocking nailing in tibia provides early mobility of patients, reduces hospital stay and fracture unites without joint stiffness and less complication.DOI: http://dx.doi.org/10.3329/bmjk.v44i1-2.10470Bang Med J (Khulna) 2011: 44(1&2) 15-17

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Saeed, Hamid, Muhammad Zia Ur Rehman, Samee Javed Bhatti, and Aamir Furqan. "CLOSED TIBIAL FRACTURES." Professional Medical Journal 25, no. 11 (November 10, 2018): 1643–48. http://dx.doi.org/10.29309/tpmj/18.4240.

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Objectives: The objective is to compare the radiological outcome of closedinterlock intramedullary nailing versus dynamic compression plating in closed tibial fracture.Study Design: Randomized controlled trials. Setting: Department of orthopedics NishtarHospital Multan. Period: 9th July 2016 to March 2017. Methodology: There were 302 patientsdivided in two equal groups of 151. Permission was taken from the ethical committee of NishtarHospital. The 302 patients in age group 20-50 years of both genders meeting the inclusionand exclusion criteria attending the outpatient clinic or admitted to the orthopedics departmentthrough emergency were included in the study. All the data entered and analyzed usingcomputer software SPSS version 10. For quantitative variables like age and duration of fracturemean and standard deviation was calculated. For categorical variables like gender, malunionand infection frequency and percentage were calculated. Chi-square test was applied tocompare the malunion and infection in both groups. A p value 0.05 was considered statisticallysignificant. Results: The 100% (n=302) patients were divided into 2 groups equally, 151 ineach, i.e. intramedullary nail (group 1) and dynamic compression plating (group 2). The mainoutcome variables of this study were the malunion and infection. It was observed that malunionpresented as 57% (n=86) and 70.9% (n=107) in group 1 and group 2 respectively. It was alsoobserved that infection presented as 23.2% (n=35) and 37.1% (n=56) in group 1 and group 2respectively. After applying chi-square test, it was noted that malunion associated with groupshaving p-value 0.012. But it was not associated with gender, stratified age and duration offracture having p-values 0.497, 0.800 and 0.218 respectively. Similarly, after applying chi-squaretest, it was noted that infection associated with gender and groups having p-values 0.007 and0.008 respectively. But it was not associated with stratified age and duration of fracture havingp-values 0.565 and 0.344 respectively. Conclusion: Closed interlock intramedullary nailinghas malunion and infection rates less than dynamic compression plating. So closed interlockintramedullary nailing is preferred method of closed tibia diaphyseal fracture treatment.

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van Heerden, Frans G., Robert M. Kirberger, and Marthinus J. Hartman. "Long Bone Fractures in Impala (Aepyceros melampus): A Classification System and Review of 55 Cases." Veterinary and Comparative Orthopaedics and Traumatology 32, no. 05 (June 3, 2019): 408–19. http://dx.doi.org/10.1055/s-0039-1691818.

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Abstract Objective The purpose of this study was to introduce a modified-Unger fracture classification in impala and report the findings of 58 long bone fractures classified according to this system. Methods This was a retrospective radiographical study evaluating 122 radiographs of 58 long bone fractures in 55 impala. The Unger fracture classification was modified and fracture illustrations for the metacarpal and metatarsal bones added. Each fracture was classified and assigned a four symbol α-numeric code using our classification. The patient signalment, skeletal maturity, fracture-associated soft tissue changes, presence of fissure lines, periosteal reaction and cause of the fracture were recorded. Results The overall fracture distribution based on location, found tibial (n = 17) fractures to be the most common fractured long bone. When combined, the majority of fractures involved the metacarpal and metatarsal bones (n = 23). Forty five of 58 fractures occurred in the diaphyseal bone segment. In all long bones, the distribution based on complexity was simple (n = 27), wedge (n = 16) and multi-fragmentary (n = 15) fractures. Thirty one of 58 fractures were open and fissure lines were detected in 20 of 58 fractures. Clinical Significance Our modified-Unger fracture classification was applicable in classifying 58 impala long bone fractures. This classification should provide the basis for further advances in veterinary and comparative ungulates, and particularly the antelopes, orthopaedics and traumatology.

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Cabassu, Julien. "Minimally Invasive Plate Osteosynthesis Using Fracture Reduction Under the Plate without Intraoperative Fluoroscopy to Stabilize Diaphyseal Fractures of the Tibia and Femur in Dogs and Cats." Veterinary and Comparative Orthopaedics and Traumatology 32, no. 06 (July 29, 2019): 475–82. http://dx.doi.org/10.1055/s-0039-1693413.

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Objective The aim of this study was to prospectively evaluate postoperative alignment when using fracture reduction under the plate (FRUP) during a minimally invasive plate osteosynthesis in tibial and femoral fractures, without intraoperative imaging, and report immediate postoperative complications. Materials and Methods After precise plate contouring and preoperative planning, FRUP was obtained with one cortical screw per fragment. Fractures were stabilized with a plate or plate rod. Tibial/femoral lengths, tibial plateau angles, mechanical medial proximal and distal tibial angles, anatomical lateral distal femoral angles, femoral curvatum and neck anteversion were evaluated on postoperative radiographs and contralateral bone. Tibial torsion was evaluated visually. Paired t-test were used to compare data. Immediate postoperative complications were recorded. Results Twenty-one tibial and 20 femoral fractures were stabilized (14 plate rod cases). Mean postoperative operated tibial length was 1.4% shorter (p = 0.001). Mean postoperative operated femoral length was 2% shorter (p = 0.04). Mean operated tibial plateau angle was 1.1° lower (p = 0.02). No difference in tibial torsion was noticed. No significant difference in mechanical medial proximal tibial angle, mechanical medial distal tibial angle, anatomical lateral distal femoral angle and femoral neck anteversion was observed. Mean operated femoral curvatum angle was 5.6° less (p = 0.01). Five cases (3 plate rod cases) required an immediate revision. Clinical Significance Minimally invasive plate osteosynthesis with FRUP leads to acceptable postoperative alignment. Correct pin placement should be evaluated.

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Jain, Saurabh, Arunangshu Mukherjee, Anand Ajmera, Ankit Verma, and Mukul Agrawal. "Outcome of limb reconstruction system in open tibial diaphyseal fractures." Indian Journal of Orthopaedics 49, no. 4 (2015): 429. http://dx.doi.org/10.4103/0019-5413.159638.

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Journal articles on the topic 'Diaphyseal tibial fractures'

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