The management of segmental tibial shaft fractures: A systematic review

Injury
Samuel E McMahonCaroline B Hing

Abstract

Segmental tibial fractures are complex injuries associated with significant soft tissue damage that are difficult to treat. This study aimed to identify the most effective method of treating segmental tibial fractures. A PRISMA compliant systematic review was conducted. Studies investigating the management of segmental tibial fractures with intramedullary nail fixation (IMN), open reduction and internal fixation (ORIF) or circular external fixation (CEF) were included for review. The primary outcome measure was time to fracture union. Secondary outcomes were complications and functional outcome. A narrative analysis was undertaken as meta-analysis was inappropriate due to heterogeneity of the data. Thirteen studies were eligible and included. No randomised controlled trials were identified. Fixation with an intramedullary nail provided the fastest time to union, followed by open reduction and internal fixation and then CEF. The rate of deep infection was highest after IMN (5/162 [3%]), followed by open reduction and internal fixation (2/78 [2.5%]) and CEF (1/54 [2%]). However, some studies reported particularly high rates of infection following IMN for open segmental tibial fractures. There was limited reporting of postoperativ...Continue Reading

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Citations

Oct 22, 2016·Journal of Orthopaedic Trauma·Richard S Yoon, Frank A Liporace
Feb 13, 2018·Journal of Orthopaedic Trauma·Robert M CoreyLisa K Cannada
Nov 2, 2018·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Sasa MilenkovicMilorad Mitkovic
Jul 7, 2021·Journal of Orthopaedic Trauma·Rajbir S HundalMark Hake

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