Segmental tibial shaft fractures.

A series of 54 cases with multiple fractures of the tibia is reported. Sixty-eight per cent of the group were pedestrians hit by a car. Fifty-two per cent were open fractures. Osteosynthesis was performed in 33 cases, whereas 21 were treated conservatively. Plate osteosynthesis was accomplished in 23 cases, seven had intramedullary nailing, and two were treated by Hoffman's external fixation device. Only one patient sustained a severe complication, viz., deep wound infection and osteomyelitis; however, even this infection was transient. All fractures healed except those sustained by two patients who died within 3 months; these deaths were, however, without any causal relationship to the osteosynthesis. One patient had a traumatic vascular lesion concomitant with the fracture, and his leg was amputated 3 days after the injury. Another patient had his leg amputated 1 year after his accident, in this case also because of injury to the vessels and nerves. It was concluded from the present series that segmental or multiple tibial shaft fractures do not entail more complications nor do they exhibit a slower rate of union than simple tibial shaft fractures if the treatssue injury.