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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%
261/2559
Operative treatment
89%
2298/2559
2. If choosing operative treatment, what would be your preferred option?
ORIF with medial plate
13%
330/2443
ORIF with lateral plate
5%
132/2443
Closed reduction and intramedullary nailing
79%
1931/2443
External Fixation
1%
32/2443
Lag screws with Sarmiento casting
0%
18/2443
3. If choosing to perform an intramedullary nail, what surgical approach would you use?
Infra-patella (hyperflexion)
83%
1970/2361
Supra-patella (semi-extended)
16%
391/2361
4. If you choose an infra-patellar approach (hyperflexion), would you split the tendon in this case?
Yes, I would split the patellar tendon
50%
1035/2031
No, I would go medial to the patellar tendon
38%
782/2031
No, I would go lateral to the patellar tendon
10%
214/2031
5. If performing intramedullary nailing, what reduction technique would you use?
Manual manipulation of leg
60%
1301/2162
Blocking screws
13%
283/2162
Percutaneous clamps
26%
578/2162
6. Would you ream this tibia?
Yes, I would ream
83%
1554/1868
No, I would not ream
16%
314/1868
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%
233/1832
Ankle radiogaphs (AP, Lat, mortise)
87%
1599/1832
8. If ankle radiographs were negative for a ankle injury, would you get additional imaging?
No, can rule out by radiographs
74%
1362/1826
Yes, would obtain a CT scan of ankle
19%
349/1826
Yes, would obtain an MRI of ankle
6%
115/1826
9. Would you perform fixation of the fibula in this case?
Yes
6%
125/2022
No
93%
1897/2022
PROCEDURE #1

ORIF with medial plate

Intra-procedure P1
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OUTCOMES
Post-procedure P1
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