Functional Cast Bracing in Selected Cases of Tibial Shaft Fracture in the Population of Odisha - A Prospective Study

Abstract

BACKGROUND Tibial shaft fracture is one of the commonest fractures encountered in orthopaedic clinics today. With recent trend being surgical management, it has increased the economic burden in developing countries like India. Thus, interest in functional cast bracing can manage many of the fractures safely with less cost and shorter hospital stay with equally good results. METHODS This prospective study included 30 patients with closed tibial shaft fracture with minimal displacements who were treated with 3 weeks of initial long leg cast followed by functional cast bracing as described by Sarmiento in 1967 with a below knee patellar tendon bearing (PTB) cast with encouraged progressive weight bearing for 6 to 9 weeks. Our goal was to achieve shortening of < 10 mm, angulations of less than 5 degrees in any plane with full range of motion at knee as per Sarmiento. RESULTS Union was seen in 25 (83 %) cases. Angulations of < 5 degrees was noted in any plane in 79 % cases. Varus and apex posterior angulations were the most common deformity. Shortening 10 mm was noted in 72 % cases with almost complete ROM of knee joint in all patients. Non-union was noticed in 2 (7 %) cases. CONCLUSIONS Functional cast bracing can still be an ideal method of management for many of the tibial shaft fractures and with better understanding of the technique and proper application, it can safely be used on other long bones as well. KEYWORDS Closed Fracture Tibia, Functional Cast Brace