[Refractures following metal removal. A follow up of surgically treated tibial shaft fractures].

This study presents the follow-up of 187 patients with 194 diaphyseal fractures of the tibia (20% open), which were operated upon between 1980 and 1984 at our institution. We were mainly interested in the question of refractures after implant removal. The majority of fractures (98.79%) had no complications after removal of the implants, but 2 patients (1.03%) sustained another fracture of the same leg between 4 and 19 months after plate removal. Both are considered to be "true" refractures, as the new fracture occurred at the original fracture site. In one case the plate was removed far too early (9 months after the initial ORIF) and no warning or additional cast was given. Two other patients sustained a new fracture at different sites 4 and 7 years after the original surgery, respectively. The possible reasons for refractures as well as the best way to prevent them are discussed.