Management of segmental tibial fractures

Abstract

Segmental tibial fractures are uncommon injuries that occur in about 12.8% of tibial fractures. They are commonly caused by high-energy trauma. It is estimated that almost 50% of these fractures are open. They are often part of multiple injuries. They are challenging to manage and have a significant complication rate.

Literature search retrieved very few articles (10) on the management of segmental tibial fractures. There has been a significant change in the management of these injuries. This has been made possible by the development of new Orthopaedic implants. Three currently favored methods of treatment are intramedullary locking nail , external Fixators (with their different constructs and versatility) and Plaster of Paris. It is important to note that more than two-thirds of segmental tibial fractures will require more than one surgical intervention. The surgeon therefore, needs to plan ahead to make subsequent surgical interventions possible.

There are no clear therapeutically- relevant guidelines regarding classification of segmental tibial fractures , treatment approaches and evaluation of functional outcome using validated scales. These are the crucial issues or challenges facing future clinical research studies.