Tibial Shaft Fractures

Question 1

bending movement

Answer 1

Transverse fracture

Question 2

Rotational movement

Answer 2

Spiral fracture

Question 3

Bending and rotation

Answer 3

Comminuted fracture

Question 4

Tibial Shaft fractures consequences

Answer 4

Fractures with the highest incidence of compartment syndrome

Often cause compartment syndrome in the anterior compartment of the leg.

Open fractures are common as tibia is subcutaneous

Question 5

Tibial shaft fracture treatment

Answer 5

Internal fixation

• position of fracture is well controlled
• ability for early joint motion

Non-operative
- above knee cast (if <50% displacement)

ORIF
- dissection to fracture site reduces periosteal blood supply slowing healing

Intramedullary nail (can cause anterior knee pain)

Question 6

Tibia healing

Answer 6

One of the slowest bones to heal

• 16 weeks to union
• 1 year to heal

Question 7

Non-union treatment

Answer 7

Bone grafting

Special circular frames which can be adjusted to alter angulation, rotation or length

Question 8

Distal tibial fractures

Answer 8

Intra-articular
- Pilan Fractures

Extra-articular

Question 9

Pilan fracture aetiology

Answer 9

High energy fall from height or rapid deceleration

Question 10

Pilan fracture investigations

Answer 10

CT scan

Question 11

Pilan fracture treatment

Answer 11

ORIF

Question 12

Pilan fracture complications

Answer 12

Can lead to post traumatic osteoarthritis

Treatment: ankle arthrodesis

Question 13

Extra-articular distal tibial fracture treatment

Answer 13

Intramedullary nail

If very distal
- plates and screws