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injuries during the last few decades. The purpose of this article is to describe current concepts of management of intra-articular distal tibial fractures with a special emphasis on the avoidance of complications. Definition According to the AO
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Proximal shaft fractures Manual laborers High-energy fractures and sports injuries Open fractures Distal tibial fractures No clear data Increased fracture length *Shaft or pilon tibial fracture, knee
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. Arch Orthop Trauma Surg 2009 ; 129 : 649 - 659 . 21 Borg T , Larsson S , Lindsjö U . Percutaneous plating of distal tibial fractures. Preliminary results in 21 patients . Injury 2004 ; 35 : 608 - 614 . 22
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complication rates reported in the treatment of metaphyseal fractures with IM nailing alone. In a systematic review incorporating 489 distal tibial fractures treated with intramedullary nailing, Zelle et al showed a nonunion rate of 5.5%, an infection rate of 4
West Hertfordshire Hospitals NHS Trust, London, United Kingdom
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School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
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DS Nayak AN Blaisdell G James CR Denard A Miles J & Santoni BG . Effect of distal interlocking screw number and position after intramedullary nailing of distal tibial fractures: a biomechanical study simulating immediate weight
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University Hospital Odense, Dep. Of Orthopedic Surgery, Sdr. Boulevard 29, 5000 Odense C, Denmark
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Crates JM . Effect of fibular plate fixation on rotational stability of simulated distal tibial fractures treated with intramedullary nailing . J Bone Joint Surg [Am] 2003 ; 85-A : 604 – 608 . 2. Wang J-Q Chen Z
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that, with an infection rate of 7.6%, this ‘common fear does not appear to be clinically grounded’, 7 an even more recent paper analysing proximal and distal tibial fractures 8 supports the view that, with an infection rate of 12% in proximal
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distal tibial fractures present with a significant soft-tissue injury and therefore pose additional complexity when managing the injury. Classification Open tibial injuries present with a spectrum of injury severity ( Fig. 1 ). It soon became
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injuries account for 40% of distal tibial fractures, and they are associated with a risk of physeal bar development of 16–25%. 40 In type II injuries the fracture crosses through the physis and the metaphysis, forming a triangular segment called
Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
Berlin Institute of Health Center for Regenerative Therapies, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, Germany
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Berlin Institute of Health Center for Regenerative Therapies, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, Germany
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Department of Orthopaedic Surgery, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark.
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
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Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
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T Schaser KD Joeris A Hess D & Duda GN . Improved weight bearing during gait at 6 weeks post-surgery with an angle stable locking system after distal tibial fracture . Gait and Posture 2024 107 169 – 176 . ( https://doi.org/10.1016/j
