- closed weight bearing treatment should be used for the majority of low energy tibial fractures;
- advantages of open treatment:
- allows early weight bearing;
- minimizes hospitalization;
- disadvantages of closed treatment:
- requires compliance w/ wt bearing & cast treatment;
- malunion occur during casting;
- subtalar stiffness;
- disadvantages of open treatment:
- plate fixation:
- risks wound dehiscence & infection;
- delayed wt bearing & refracture (following plate removal) are common;
- external fixation:
- requires frequent adjustments;
- pin tract infections;
- malunion may occur w/ change of Ex Fix to Cast;
- high infection rate may occur w/ change of ExFix to IM nailing, (especially with pin tract infections)
Posterolateral bone graft of the tibia.
Early prophylactic bone grafting of high-energy tibial fractures.
Acute and definitive management of traumatic osteocutaneous defects of the lower extremity.