31. Open and closed tibia fractures – treatment and rehabilitation

Question 1

How do you evaluate a tibia fracture?

Answer 1

Evaluate neurovascular status of distal limb (especially in open fractures)

X-ray: AP and lateral views

Question 2

What is the nonoperative treatment of tibia fracture?

Answer 2

For isolated, closed fractures, with minimal displacement The average time until union is 16 ± 4 weeks
Delayed union is > 20 weeks

Question 3

What is the operative treatment of tibia fracture?

Answer 3

• Intramedullary Nailing: preserves periosteal blood supply, recommended for most fracture patterns.
• Locked nails: provides rotational control
• Unreamed Nails: designed to preserve the IM blood supply in open fractures

Question 4

What is the problem with Proximal Tibia Fractures?

Answer 4

• notoriously difficult to nail
• Nailing requires use of special techniques such as blocking screws.