X rays: for Tibial Frx



- comminution:
    - more than 50% cortical comminution is considered significant and increases chance of non union;

- displacement:
    - > 50% frx displacement will significantly increase risk of non-union, due to instability of frx and predisposition for future displacement (if treated closed);

- accetable reduction:
    - > 10 deg of angulation in any plane is unacceptable
    - <  5 deg of varus or valgus;
    - < 10 deg of anterior or posterior angulation;
    - < 10 deg of rotation;
    - <  1 cm for leg length discrepancy;
    - no distraction is tolerated;
          - distraction > 1.6 mm may affect length of healing;
          - 5 mm of distraction may increase healing time to 8-12 months;
    - as noted by Milner SA (1997), there is a considerable amount of tibial shaft alignment variety, and therefore, when there is a question of whether reduction is acceptable, x-rays of the opposite leg should be obtained;
          - this author noted that the mechanical axis of the normal tibia may not pass down the center of the medullary canal;
          - ref: A more accurate method of measurement of angulation after fractures of the tibia



Posterior malleolar fracture is often associated with spiral tibial diaphyseal fracture: a retrospective study



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Monday, July 30, 2012 4:48 pm