Tibia shaft fracture

Question 1

Sensibility test

Answer 1

include also n. peroneus profundus between toe I and II

Question 2

Compartment pressure

Answer 2

normal <15 mmHg
> 30 mmHg pathologic
delta P = MAP - compartment pressure, if < 30 : decompress

Question 3

Operation indication

Answer 3

Malrotation > 10° (ER better tolerated as IR)
Axis >5°(10°)
Length max +/- 5mm

But generally OR indication if fit for surgery

Question 4

Choice of implant

Answer 4

whenever possible :
Expert Tibia nagel
Cold reaming to 11mm
10mm Nail !!

If nailing not possible, LC DCP 4.5 and lag screws 3.5

Question 5

2 step fix ex and then plate/nail

Answer 5

Possible if done within 10-14 days
No increased infection risk if pin not infected
Checketts Otterburn

Question 6

Pseudarthrose Treatment

Answer 6

Atrophic : dekortikation, spongiosaplastic

Hypertrophic : restabilisation