On the behavior of closed tibial fractures: clinical/radiological correlations.

OBJECTIVE

To review the treatment of closed diaphyseal tibial fractures with functional braces and to identify patient and fracture characteristics, as well as possible correlations, that could be used to determine final outcomes.

DESIGN

A comprehensive review of data obtained from 1,000 diaphyseal tibial fractures.

SETTING

Major university teaching hospital.

INTERVENTION

Identification of patient and fracture characteristics, including type and level of fracture, initial shortening and angulation, and severity of injury, to be correlated with final shortening and angulation and speed of healing.

MAIN OUTCOME MEASUREMENTS

Degree of shortening and angulation; speed of healing.

RESULTS

Neither the level nor the type of tibial fracture significantly influenced healing time, although there was a considerably higher probability of delayed union in fractures produced from vehicular accidents, as well as in comminuted and segmental fractures. Any delay in application of the functional brace resulted in slower healing. Maximum shortening of the fractures occurred at the time of the initial injury, with no additional shortening experienced after the introduction of graduated weight-bearing ambulation. Compared with a mean initial shortening of 4.25 millimeters, the overall final shortening of fractures was 4.28 millimeters.

CONCLUSIONS

Correlations exist between patient and fracture characteristics that influence the final outcome for closed diaphyseal fractures treated with functional braces.