Secondary treatment of fractures of the middle and lower third of the tibia unsuccessfully treated by primary internal fixation.

The authors present forty six cases, referred to us between 1969 and 1974, of fracture of the middle and lower thirds of the tibia, previously treated elsewhere by primary internal fixation using a plate and screws. The causes of failure are divided into defective indications and defective technique. The methods of treatment used in infected and non-infected lesions are described. They criticise the unnecessary use of plates and explain their reasons. They do not condemn the method outright, since in selected cases IT IS UNDOUBTEDLY A VALID METHod of treatment. They are opposed, however, to its indiscriminate use for lesions that may perfectly well be cured, with the minimum risk, either by conservative methods, or by intramedullary nailing.