Classification of Tibial Shaft Fractures and Correlation with Results after Rigid Internal Fixation

Johner, R; Wruhs, O

doi:10.1097/00003086-198309000-00003

Cited by 251 publications

(151 citation statements)

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“…Utilizando a classificação proposta por Johner et al (25) , tivemos 12 pacientes (33,3%) com fraturas tipo A, 18 (50,0%) com fraturas tipo B e seis (16,7%) com fraturas tipo C. Subdividindo as fraturas tipo A (tabela 2), dois pacientes (5,6%) sofreram fraturas A1; três (8,3%), fraturas A2; e sete (19,4%), fraturas A3. Subdividindo as fraturas tipo B, dois pacientes (5,6%) sofreram fraturas B1; 13 (36,1%), fraturas B2; e três (8,3%), fraturas B3.…”

Section: Resultsunclassified

“…Da análise da literatura sobre a fixação de fraturas expostas da diáfise da tíbia com Pinless ® , pudemos observar que nossa casuística é semelhante à de outros autores, havendo gravidade maior que a de outros trabalhos (11)(12)(23)(24)27) , por ocorrer predomínio de fraturas expostas grau II de Gustilo et al (20) e do tipo B da classificação de Johner et al (25) .…”

Section: Discussionunclassified

“…Cada tipo foi subdividido em três grupos, de acordo com o mecanismo de trauma: por torção, por flexão ou por cisalhamento (25) .…”

Section: Introductionunclassified

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Osteossíntese provisória das fraturas expostas da diáfise da tíbia com fixador externo não transfixante

Hungria¹,

Mercadante²

2008

Rev. bras. ortop.

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Section: Resultsunclassified

Section: Discussionunclassified

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Osteossíntese provisória das fraturas expostas da diáfise da tíbia com fixador externo não transfixante

Hungria¹,

Mercadante²

2008

Rev. bras. ortop.

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“…The description of malalignment as being compatible with good long-term function remains controversial [4,8,11,13,14,17,18]. We have used the most common guidelines for an acceptable reduction of a tibial shaft fracture [4,9,16]. We conclude that in spiral, closed or grade I open, tibial shaft fractures in the middle or lower third of the shaft, with concomitant fibular fracture and with a true initial displacement exceeding 30% of the diaphyseal diameter, the incidence of loss of reduction after cast treatment is unacceptably high.…”

Section: Discussionmentioning

confidence: 99%

Which displaced spiral tibial shaft fractures can be managed conservatively?

Toivanen

Kyrö

Heiskanen

et al. 2000

International Orthopaedics

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The aim of the present study was to establish a threshold for the initial displacement of a spiral tibial shaft fracture beyond which its retention in an acceptable position cannot be guaranteed by plaster immobilization. We reviewed the records and radiographs of 131 plaster cast-treated patients with spiral tibial shaft fracture, initially displaced 50% or less, for patients whose fracture had either lost its acceptable retention or consolidated in an unacceptable position. The fractures were classified, according to the true initial displacement as measured on the first radiographs, into four pairs of categories using cut-off points of 10, 20, 30 and 40% of the diameter of the tibial diaphysis. Comparison was then made of the proportions of failed treatments between each of these pairs. Plaster cast treatments failed in 28% when the true initial displacement was 30% or less, and in 46% when the true initial displacement was more than 30%. The risk of failed plaster cast treatment increased when true initial displacement exceeded 30%. In all patients whose plaster cast treatment was interrupted the true initial displacement was more than 30%. We therefore conclude that diaphyseal fractures of the tibia for which the initial displacement exceeds 30% are not suitable for plaster cast treatment.Résumé L'objectif de cette étude était de déterminer le seuil de déplacement initial des fractures spiroïde du tibia après lequel la position acceptable ne peut être garantie sous immobilisation plâtrée. Nous avons revu les dossiers et les radiographies de 131 patients plâtrés présen-tant une fracture spiroïde du tibia avec un déplacement initial de 50% ou moins, pour découvrir les patients dont les fractures, soit ont perdu une réduction acceptable, soit se sont consolidées dans une position non-acceptable. Les fractures ont été classées selon le déplacement initial réel, mesurées sur les radiographies d'entrée. Quatre paires de catégories ont été crées en utilisant comme points de mesure, à savoir: 10, 20, 30 et 40% du diamè-tre de la diaphyse du tibia. Puis les proportions des traitements non réussies entre chacune des ces paires étaient comparées. Les traitements sous plâtre ont abouti à l´échec dans 28% des cas quand le déplacement initial réel était de 30% ou moins, et dans 46% des cas quand le déplacement initial réel était plus que 30%. Le risque de l'échec de traitement par plâtre n'a augmenté que légère-ment quand le déplacement initial a dépassé les30%. Le degré de déplacement initial réel des fractures dont les traitements plâtrés ont été interrompus était de plus de 30%. Ainsi nous aboutissons à la conclusion que les fractures de la diaphyse tibiale dont le déplacement initial dépasse 30% ne conviennent pas pour le traitement par immobilisation plâtrée.

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“…The case descriptions of both groups were analyzed according to the parameters age, sex, fracture side, trauma mechanism, occurrence of fibular fracture, associated lesions, and classifications according to AO group, 16 Tscherne, 17 and Gustilo. 18 There were no significant differences regarding these parameters.…”

Section: Introductionmentioning

confidence: 99%

Comparative Study of the Locked Intramedullary Nail and Ender Pins in the Treatment of Tibial Diaphyseal Fractures

Sakaki

Crocci

Zumiotti

2007

Clinics

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MATERIALS AND METHODS:Forty-four patients with unilateral tibial diaphyseal fractures were treated with intramedullary nails or Ender pins. Twenty patients were treated with an unreamed intramedullary nail with access via the patellar tendon with static locking. Twenty-four patients were treated with Ender pins introduced medially and laterally with respect to the tuberosity of the tibia. The main parameters analyzed were type of reduction, complications, union rate, deformities, joint mobility, pain, gait, effort capacity, presence of neurovascular disorders, and complaints related to the synthesis material. RESULTS: During 1 year of follow-up, the fractures of 90.0% of the patients with intramedullary nails and 95.7% of patients with Ender pins healed within an average of 21.5 weeks and 20.9 weeks, respectively. The significant findings were as follows: patients treated with Ender pins had less mobility of the subtalar joint; patients treated with intramedullary nails were more likely to have pain in the knee; both groups showed shortening of the tibia at the end of 1 year of treatment. CONCLUSIONS:The two methods are similar in the treatment of type A, B, and C2 tibial diaphyseal fractures.

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Classification of Tibial Shaft Fractures and Correlation with Results after Rigid Internal Fixation

Cited by 251 publications

References 0 publications

Osteossíntese provisória das fraturas expostas da diáfise da tíbia com fixador externo não transfixante

Osteossíntese provisória das fraturas expostas da diáfise da tíbia com fixador externo não transfixante

Which displaced spiral tibial shaft fractures can be managed conservatively?

Comparative Study of the Locked Intramedullary Nail and Ender Pins in the Treatment of Tibial Diaphyseal Fractures

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