A Clinical Study of Tibial Shaft Fractures

Chung, I H; Kang, K S; Ahn, J I; Oh, H Y; Kang, E S; Joo, C S

Abstract

One hundred and eighty five patients with a fracture of tibial shaft have been treated and managed in the Department of Orthopedic Surgery, Wonju Christian Hopital from January 1972 to December, 1978, A clinical study was done on 130 cases (6 bilateral) that could be followed up among 185 patients. The results were as follows; 1. The rate of fracture union was accelerated under the age of 20 years but it was slow in older patients, and the rate of delayed union, nonunion, and joint stiffness except malunion was increased in aged group. 2. The union time of the tibial shaft fracture was more rapid by a week in the proximal one third of th tibia than the middle lower one thirds, but the rate of malunion was higher in the lower one third than in the proximal and middle thirds of the tibia. 3. The worse prognosis of the fracture type was shown in segmental and comminuted fracture than any other. 4. There was a relatively decreased rate of union in cases of associated fibular fracture. 5. Open fractures of the tibia united later than closed ones and the rate of delayed union, nonunion, malunion, infection, and joint stiffness was markedly increased in open fractures. 6. According to the modified Ellis classification, the major severity group showed the worst prognosis. 7. Earlier weight bearing showed more rapid rate of fracture union, and more decreased rate of delayed union, nonunion, and joint stiffness except malunion. 8. The mean healing time of tibial fracture was 18. 7 weeks in the most patients under the age of 20 years treated withe a long leg cast only, 19. 6 weeks in patients managed with the other conservative methods, over all 17.4 weeks with conservative treatment, and 18.7 weeks in patients managed with operative treatment. The rate of delayed union, nonunion, and infection was higher in operative than conservative treatment, however, all the malunion and joint stiffness were observed in this treatment group.