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tibial fracture
Classification:
1) tibial shaft fractures (most common type)
- occur in the shaft of tibia
2) tibial plateau fractures
- occur just below the knee joint
3) plafond fractures
- occur around the ankle joint
Complications:
- risk of deep vein thrombosis is 0.6% [1]
- compartment syndrome [4]
Management:
- orthopedic surgery
- immobilization
- two bone morphogenetic proteins are used in special circumstances
- Infuse (BMP2)
- used for treating open tibial shaft fractures
- Osigraft (BMP7)
- indicated in treatment of traumatic tibial fracture with non-union of at least 9 months duration in skeletally mature patients, in cases where autograft has failed or is unfeasible
- DVT prophylaxis unnecessary [1]
- low-intensity pulsed ultrasound (FDA-approved) to accelerate fracture healing & avert nonunion but of no benefit [2]
Related
tibia
Specific
medial malleolar fracture
tibial shaft fracture
General
bone fracture
References
- Selby R et al.
Symptomatic venous thromboembolism uncommon without
thromboprophylaxis after isolated lower-limb fracture: The
Knee-to-Ankle Fracture (KAF) cohort study.
J Bone Joint Surg Am 2014 May 21;
PMID: 24875035
http://jbjs.org/content/96/10/e83
- Selby R et al.
PAPER 031: CLINICALLY-IMPORTANT VENOUS THROMBOEMOLISM (CIVTE)
FOLLOWING ISOLATED LEG FRACTURES DISTAL TO THE KNEE:
EPIDEMIOLOGY & PREVENTION: THE D-KAF (DALTEPARIN IN KNEE-
TO-ANKLE FRACTURE) TRIAL.
J Bone Joint Surg Br 2010 vol. 92-B. no. SUPP I 7
http://www.bjjprocs.boneandjoint.org.uk/content/92-B/SUPP_I/7.3.abstract
- Busse JW, Bhandari M, Einhorn TA et al.
Re-evaluation of low intensity pulsed ultrasound in treatment
of tibial fractures (TRUST): Randomized clinical trial.
BMJ 2016 Oct 25; 355:i5351.
PMID: 27797787 Free Article
http://www.bmj.com/content/355/bmj.i5351
- Griffin XL.
Low intensity pulsed ultrasound for fractures of the tibial
shaft: We now have sound evidence that it doesn't work.
BMJ 2016 Oct 25; 355:i5652
PMID: 27780808 Free PMC Article
http://www.bmj.com/content/355/bmj.i5652
- Cluett J
Tibia Fracture
http://orthopedics.about.com/od/brokenbones/a/tibia.htm
- Barnes DK, Randhawa SDS, Fitzpatrick EP.
Under Pressure: Delayed Diagnosis of Compartment Syndrome after Lower Leg Fracture.
PSNet. April 24, 2024
https://psnet.ahrq.gov/web-mm/under-pressure-delayed-diagnosis-compartment-syndrome-after-lower-leg-fracture