Fractures of the tibial diaphysis in adults with head injuries.

The charts and roentgenograms of 41 adult patients with severe head injuries who sustained 47 tibial shaft fractures were reviewed. Twenty-seven (57%) of the fractures were open and the incidence of peroneal nerve injury was 17%. The average time to weight-bearing was 3.1 months. Closed fractures united at 5.4 months and open fractures at 5.8 months. Three nonunions (6.5%) occurred in 2 patients. This review failed to demonstrate either an early rate of union or an abnormally high union rate. Furthermore, exuberant callus was not observed roentgenographically. Tibia fractures in adults with head injuries, whether on the normal or paralyzed extremity, appeared to heal in a fashion similar to fractures in normal patients. Conventional methods of treatment render satisfactory results.