Incidence and epidemiology of tibial shaft fractures

Larsen, Peter; Elsøe, Rasmus; Hansen, Sandra Hope; Graven‐Nielsen, Thomas; Læssøe, Uffe; Rasmussen, Sten

doi:10.1016/j.injury.2014.12.027

Cited by 180 publications

(115 citation statements)

References 10 publications

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“…population per year. [1][2] Open fractures account for approximately 20% of diaphyseal tibial fractures (3.4 per 100,000 population per year) and recent epidemiological data suggest that approximately 20% of these are Gustilo-Anderson (GA) IIIB. 3 These severe osteocutaneous injuries are associated with high rates of complications and present a reconstructive challenge.…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Comparative Cohort Study Comparing Temporary Internal Fixation to External Fixation at the First Stage Debridement in the Treatment of Type IIIB Open Diaphyseal Tibial Fractures

Fowler

Whitehouse

Riddick

et al. 2019

Journal of Orthopaedic Trauma

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Objectives: To compare the rates of deep infection, flap failure and nonunion after temporary internal fixation (TIF), with temporary external fixation (ex-fix) in the management of Gustilo-Anderson (GA) type IIIB open tibia fractures. Design: Retrospective comparative cohort. Setting: Level 1 trauma center. Patients/Participants: 64 consecutive patients with a GA type IIIB open diaphyseal tibia fracture (OTA/AO 42) were treated between May 2014 and May 2016. 47 patients (TIF = 24; ex-fix = 23) met the inclusion criteria and underwent two-stage reconstruction. Definitive fixation was with an intramedullary nail.Intervention: Temporary fracture stabilization at the first stage debridement was achieved with either TIF with a plate, or ex-fix. Main Outcome Measurement: Deep infectionResults: There were 4 complications in the ex-fix group (3 infection and 1 nonunion) and 2 complications in the TIF group (1 infection and 1 flap failure). Multiple regression modelling revealed infection (p=0.610), nonunion (p=0.918) and flap failure (p=0.112) were not significantly associated with the mode of temporary fixation or other demographic and treatment variables. The odds ratio of patients treated with TIF developing an infection compared to those treated with an ex-fix was 0.29 (95% CI 0.03 to 3.01).Conclusion: TIF of type IIIB open diaphyseal tibial fractures appears to be a safe alternative to conventional external fixation. Level of Evidence: Therapeutic Level III

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Section: Introductionmentioning

confidence: 99%

A Retrospective Comparative Cohort Study Comparing Temporary Internal Fixation to External Fixation at the First Stage Debridement in the Treatment of Type IIIB Open Diaphyseal Tibial Fractures

Fowler

Whitehouse

Riddick

et al. 2019

Journal of Orthopaedic Trauma

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“…While there are numerous epidemiological studies regarding different types of fractures, pathological changes and surgical interventions, such as hip replacements, they mostly report incidence (as opposed to prevalence), are focused on a single type of injury or illness, derived from single hospitals or specific regions, and naturally include patients who had accessed medical care (, to name just a few). In this study, some of the features that are considered rare in incidence studies were shown to cluster in a specific age‐group, such as button osteoma in the 80+‐year‐old individuals.…”

Section: Discussionmentioning

confidence: 99%

The Utility of Skeletal and Surgical Features for the Personal Identification Process: A Pilot Study

Cappella

Gibelli

Obertová

et al. 2019

Journal of Forensic Sciences

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This pilot study provides a conceptual framework for the application of the anthropological analysis of skeletal features and surgical interventions for the purpose of identification in cases of unknown deceased individuals with unavailable fingerprint, genetic or odontological antemortem data. The study sample includes 276 individuals with known demographic and clinical information from the Italian CAL Milano Cemetery Skeletal Collection. In the sample, 124 (45%) individuals showed one or more skeletal features that may be potentially individualizing. Of these, 79% showed two and more features, which occurred in a multitude of different combinations. Skeletal findings may provide useful postmortem information that can be compared with antemortem witness statements and clinical imaging. However, more research into the utility of dry bone findings and the availability of comparative material, including imaging, and epidemiological data needs to be undertaken before skeletal features can be implemented into identification protocols and databases.

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“…Tibial fractures can successfully be treated with intramedullary nailing (IMN) [1][2][3]. However, distal tibiashaft fractures are challenging as the expanding diaphysis going to the metaphysis increases the size of the intramedullary canal [4].…”

Section: Introductionmentioning

confidence: 99%

Clinical and Radiographic Comparisons of Distal Tibia Shaft Fractures Stabilized with an Intramedullary Nail: Blocking Pin Versus Blocking Screw

Wu¹,

Bai²,

Song³

et al. 2020

Preprint

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Background: Distal tibia shaft fractures have a high risk of mal-alignment when treated with intramedullary nailing (IMN). Permanent blocking screws (BSs) and temporary blocking pins (BPs) are often used as supplements to help IMN get good alignment. The purpose of this study was to compare the clinical and radiographic outcomes of temporary BPs and permanent BSs for distal tibia shaft fractures.Methods: From March 2014 to May 2019, a total of 89 patients with distal tibia shaft fractures were included in this retrospective study and divided into two groups. All fractures were located below the isthmus but 4 cm above the tibial plafond. The differences in operating time, intraoperative bleeding, fibula plate fixation, number of BP/BS, initial and final alignment, loss of reduction, fracture healing time, and postoperative complications were analyzed. Functional outcomes of the ankle were assessed with the American Orthopedic Foot and Ankle Society (AOFAS) score.Results: All patients underwent a minimum follow-up of 13 months. The operating time was (73.9±6.1) min and (80.2±8.6) min in the BP group and BS group, respectively (P < 0.05); intraoperative bleeding was (88.2±18.0) mL and (92.9±26.6) mL, respectively (P > 0.05); initial reduction deformity in coronal plane was (0.5±2.3) degrees and (0.9±2.3) degrees, respectively (P > 0.05); final alignment deformity in coronal plane was (1.2±2.7) degrees and (1.3±2.4) degrees, respectively (P > 0.05); initial reduction deformity in sagittal plane was (0.6±2.2) degrees and (0.6±2.4) degrees, respectively (P > 0.05); final alignment deformity in sagittal plane was (0.9±2.3) degrees and (1.0±2.2) degrees, respectively (P > 0.05); As for the loss of reduction, there was no significant difference in sagittal plane between the two groups(P > 0.05). Although the loss of reduction in the coronal plane of the BP group (0.8±0.7 degrees) is statistically higher than that of the BS group (0.5±0.5 degrees), the small difference was not clinically important (P < 0.05). No significant differences were found between the two groups in fracture healing time, AOFAS score and complications (P > 0.05).Conclusion: Both temporary BP and permanent BS can help achieve equivalent overall alignment. However, BP technique is simpler and takes less time.

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Incidence and epidemiology of tibial shaft fractures

Cited by 180 publications

References 10 publications

A Retrospective Comparative Cohort Study Comparing Temporary Internal Fixation to External Fixation at the First Stage Debridement in the Treatment of Type IIIB Open Diaphyseal Tibial Fractures

A Retrospective Comparative Cohort Study Comparing Temporary Internal Fixation to External Fixation at the First Stage Debridement in the Treatment of Type IIIB Open Diaphyseal Tibial Fractures

The Utility of Skeletal and Surgical Features for the Personal Identification Process: A Pilot Study

Clinical and Radiographic Comparisons of Distal Tibia Shaft Fractures Stabilized with an Intramedullary Nail: Blocking Pin Versus Blocking Screw

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