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Tibial Shaft Fractures
Posted: Feb 27 2016 #(C2518)
A

Closed Tibia-Fibula Spiral Fracture in 31M

HPI

ski injury

PMH

PE

Tscherne Classification=0 Minimal soft tissue damage indirect injury to limb (torsion) simple fracture pattern

Poll
1 of 9
1. How would you treat this fracture?
Closed reduction and cast immobilization
10%
261/2555
Operative treatment
89%
2294/2555
2. If choosing operative treatment, what would be your preferred option?
ORIF with medial plate
13%
330/2438
ORIF with lateral plate
5%
132/2438
Closed reduction and intramedullary nailing
78%
1926/2438
External Fixation
1%
32/2438
Lag screws with Sarmiento casting
0%
18/2438
3. If choosing to perform an intramedullary nail, what surgical approach would you use?
Infra-patella (hyperflexion)
83%
1969/2356
Supra-patella (semi-extended)
16%
387/2356
4. If you choose an infra-patellar approach (hyperflexion), would you split the tendon in this case?
Yes, I would split the patellar tendon
51%
1034/2026
No, I would go medial to the patellar tendon
38%
778/2026
No, I would go lateral to the patellar tendon
10%
214/2026
5. If performing intramedullary nailing, what reduction technique would you use?
Manual manipulation of leg
60%
1300/2157
Blocking screws
13%
281/2157
Percutaneous clamps
26%
576/2157
6. Would you ream this tibia?
Yes, I would ream
83%
1549/1863
No, I would not ream
16%
314/1863
7. How would you evaluate the ankle for a concomitant osseous ankle injuries in this case?
AP and Lateral of leg (tib-fib) is enough
12%
232/1827
Ankle radiogaphs (AP, Lat, mortise)
87%
1595/1827
8. If ankle radiographs were negative for a ankle injury, would you get additional imaging?
No, can rule out by radiographs
74%
1358/1821
Yes, would obtain a CT scan of ankle
19%
348/1821
Yes, would obtain an MRI of ankle
6%
115/1821
9. Would you perform fixation of the fibula in this case?
Yes
6%
125/2017
No
93%
1892/2017
PROCEDURE #1

ORIF with medial plate

Intra-procedure P1
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OUTCOMES
Post-procedure P1
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