Failed Fixation of the Tibial Shaft

Summary Tibial shaft fractures are prone to healing problems. The poor soft tissue envelope surrounding the tibia, in combination with the frequency of high-energy fractures, results in frequent problems with union and failed fixation. Infection and malalignment are associated with failure to heal. This chapter reviews the causes and treatment options for ununited tibial shaft fractures.

[1]  R. Jakob,et al.  Sequential intramedullary nailing of open tibial shaft fractures after external fixation , 2004, Archives of Orthopaedic and Trauma Surgery.

[2]  C. Lavy,et al.  Wound healing after implant surgery in HIV-positive patients. , 2002, The Journal of bone and joint surgery. British volume.

[3]  G. Zych,et al.  Rates and Odds Ratios for Complications in Closed and Open Tibial Fractures Treated With Unreamed, Small Diameter Tibial Nails: A Multicenter Analysis of 467 Cases , 2001, Journal of orthopaedic trauma.

[4]  D. Deheer,et al.  Reversal of the Detrimental Effects of Chronic Protein Malnutrition on Long Bone Fracture Healing , 2001, Journal of orthopaedic trauma.

[5]  J. Keating,et al.  Cigarette smoking and open tibial fractures. , 2001, Injury.

[6]  D. Macdonald,et al.  Nonunion of the femoral diaphysis , 2000 .

[7]  D. Macdonald,et al.  Nonunion of the femoral diaphysis. The influence of reaming and non-steroidal anti-inflammatory drugs. , 2000, The Journal of bone and joint surgery. British volume.

[8]  R. Sanders,et al.  Treatment of Complex Tibial Periarticular Fractures Using Percutaneous Techniques , 2000, Clinical orthopaedics and related research.

[9]  A. Schmidt,et al.  A prospective, randomized study of intramedullary nails inserted with and without reaming for the treatment of open and closed fractures of the tibial shaft. , 2000, Journal of orthopaedic trauma.

[10]  J. Styf,et al.  Displaced tibial shaft fractures: A prospective randomized study of closed intramedullary nailing versus cast treatment in 53 patients , 2000, Acta orthopaedica Scandinavica.

[11]  G H Guyatt,et al.  Reamed versus nonreamed intramedullary nailing of lower extremity long bone fractures: a systematic overview and meta-analysis. , 2000, Journal of orthopaedic trauma.

[12]  M. Finnegan,et al.  Effect of smoking on tibial shaft fracture healing. , 1999, Clinical orthopaedics and related research.

[13]  M. V. van Holsbeeck,et al.  Ultrasound for the early diagnosis of tibial fracture healing after static interlocked nailing without reaming: clinical results. , 1998, Journal of orthopaedic trauma.

[14]  M. Swiontkowski,et al.  Treatment of type II, IIIA, and IIIB open fractures of the tibial shaft: a prospective comparison of unreamed interlocking intramedullary nails and half-pin external fixators. , 1998, Journal of orthopaedic trauma.

[15]  C. Krettek,et al.  Superior Results of Tibial Rodding Versus External Fixation in Grade 3B Fractures , 1997, Clinical orthopaedics and related research.

[16]  P. Blachut,et al.  Interlocking intramedullary nailing with and without reaming for the treatment of closed fractures of the tibial shaft. A prospective, randomized study. , 1997, The Journal of bone and joint surgery. American volume.

[17]  J. Keating,et al.  Locking Intramedullary Nailing with and without Reaming for Open Fractures of the Tibial Shaft. A Prospective, Randomized Study* , 1997, The Journal of bone and joint surgery. American volume.

[18]  P. Levin Exchange reamed intramedullary nailing for delayed union and nonunion of the tibia. , 1996, Clinical orthopaedics and related research.

[19]  W. Stetson,et al.  Tibial Nonunion: Treatment Alternatives , 1996, The Journal of the American Academy of Orthopaedic Surgeons.

[20]  C. Court-Brown,et al.  Reamed or unreamed nailing for closed tibial fractures. A prospective study in Tscherne C1 fractures. , 1996, The Journal of bone and joint surgery. British volume.

[21]  C. Turen,et al.  Skeletal stabilization for tibial fractures associated with acute compartment syndrome. , 1995, Clinical orthopaedics and related research.

[22]  J. Keating,et al.  Exchange intramedullary nailing. Its use in aseptic tibial nonunion. , 1995, The Journal of bone and joint surgery. British volume.

[23]  M. Lorio,et al.  Management Protocol for Unreamed Interlocking Tibial Nails for Open Tibial Fractures , 1995, Journal of orthopaedic trauma.

[24]  C. Krettek,et al.  Outcome of tibial shaft fractures with severe soft tissue injury treated by unreamed nailing versus external fixation. , 1994, The Journal of trauma.

[25]  R. Sanders,et al.  The Treatment of Open Tibial Shaft Fractures Using an Interlocked Intramedullary Nail Without Reaming , 1994, Journal of orthopaedic trauma.

[26]  J. France,et al.  Prospective Study of Union Rate of Open Tibial Fractures Treated with Locked, Unreamed Intramedullary Nails , 1994, Journal of orthopaedic trauma.

[27]  P. Tornetta,et al.  Treatment of grade-IIIb open tibial fractures. A prospective randomised comparison of external fixation and non-reamed locked nailing. , 1994, The Journal of bone and joint surgery. British volume.

[28]  P. Kirchner,et al.  Diagnosis of infection in ununited fractures. Combined imaging with indium-111-labeled leukocytes and technetium-99m methylene diphosphonate. , 1993, The Journal of bone and joint surgery. American volume.

[29]  B. Riemer,et al.  Comparison of Reamed and Nonreamed Solid Core Nailing of the Tibial Diaphysis After External Fixation: A Preliminary Report , 1993, Journal of orthopaedic trauma.

[30]  B. Sangeorzan,et al.  The Effect of Talar Neck Misalignment on Subtalar Joint Contact Characteristics , 1992 .

[31]  S. Gasser,et al.  Indirect reduction and tension-band plating of tibial non-union with deformity. , 1992, The Journal of bone and joint surgery. American volume.

[32]  D. Johnson,et al.  Compression plating for non-union after failed external fixation of open tibial fractures. , 1992, The Journal of bone and joint surgery. American volume.

[33]  J. Keating,et al.  Infection after intramedullary nailing of the tibia. Incidence and protocol for management. , 1992, The Journal of bone and joint surgery. British volume.

[34]  J. Taylor,et al.  Treatment of open fractures of the tibial shaft with the use of interlocking nailing without reaming. , 1992, The Journal of bone and joint surgery. American volume.

[35]  H. Törnqvist Tibia Nonunions Treated by Interlocked Nailing: Increased Risk of Infection After Previous External Fixation , 1990, Journal of orthopaedic trauma.

[36]  P. Blachut,et al.  External fixation and delayed intramedullary nailing of open fractures of the tibial shaft. A sequential protocol. , 1990, The Journal of bone and joint surgery. American volume.

[37]  E. E. Johnson,et al.  Delayed intramedullary nailing after failed external fixation of the tibia. , 1990, Clinical orthopaedics and related research.

[38]  H. An,et al.  Posterolateral Bone Graft of the Tibia , 1990, Clinical orthopaedics and related research.

[39]  J. Kellam,et al.  Plate Fixation of Open Fractures of the Tibia , 1988, The Journal of bone and joint surgery. British volume.

[40]  E. V. Lim,et al.  Treatment of open tibial-shaft fractures. External fixation and secondary intramedullary nailing. , 1988, The Journal of bone and joint surgery. American volume.

[41]  R. Galpin,et al.  Treatment of failures after plating of tibial fractures. , 1986, The Journal of bone and joint surgery. American volume.

[42]  J. Webb,et al.  Experience with the dynamic compression plate (DCP) in 418 recent fractures of the tibial shaft. , 1976, Injury.