Treating tibial fractures with a modified Sarmiento method.

There is still no unanimous agreement on the appropriate primary treatment of tibial fractures. One fraction advocates conservative treatment, and another advocates open reduction and internal fixation. Between these extremes is the functional treatment developed by Augusto Sarmiento. The authors adopted Sarmiento's method in 1976 and present a prospective study of 317 cases treated between 1976 and 1988 in which the union rate was 98.7%. They describe the Sarmiento method as ideal for closed, spiroid (whether comminuted or not) tibial fractures resulting from low-energy forces.