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Luke Turley Department of Orthopaedics, Midland Regional Hospital Tullamore, Tullamore, Ireland

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Ian Barry Department of Plastic Surgery, Royal Perth Hospital, Perth, Western Australia, Australia

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Eoin Sheehan Department of Orthopaedics, Midland Regional Hospital Tullamore, Tullamore, Ireland

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Introduction Fractures of the tibial shaft represent 2% of all fractures and 37% of all long bone fractures in adults, at an incidence of 17–21 per 100,000 population ( 1 , 2 ). Due to the limited soft tissue coverage specific to the tibial

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Vanessa Morello Division of Orthopaedic and Trauma Surgery, University Hospitals of Geneva, Geneva, Switzerland

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Axel Gamulin Division of Orthopaedic and Trauma Surgery, University Hospitals of Geneva, Geneva, Switzerland

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occurrence in tibial plateau fractures reaches 12% and even 53% in higher-energy patterns ( 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 ). In tibial shaft fractures, ACS occurrence reaches 11.5% ( 10

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Salvi Prat-Fabregat Hospital Clinic of Barcelona, Spain

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Pilar Camacho-Carrasco Hospital Clinic of Barcelona, Spain

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Tibial plateau fractures (TPFs) are common and difficult-to-manage injuries that can be due to high- or low-energy trauma and can affect young adults or third-age patients. When faced with one of these injuries there are some questions to be

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Abdel Rahim Elniel Leeds Teaching Hospitals Trust, UK

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Peter V. Giannoudis Academic Department of Trauma and Orthopaedics, Leeds Teaching Hospitals, University of Leeds, UK; NIHR Leeds Biomedical Research Unit, Chapel Allerton Hospital, UK

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therefore severity. Table 3. Recent studies on the clinical outcomes of Gustilo type III tibial shaft fractures Study n IM nail Union time (weeks) Infection (n (%)) Malunion (n (%)) Re-operation Naique 2006 48 26

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Alexandre Sitnik Belarus Republic Scientific and Practical Center for Traumatology and Orthopedics, Kizhevatova str 60-4, 220024 Minsk, Belarus

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Aleksander Beletsky Belarus Republic Scientific and Practical Center for Traumatology and Orthopedics, Kizhevatova str 60-4, 220024 Minsk, Belarus

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Steven Schelkun Naval Hospital, San Diego, California, USA

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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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Hakan Ömeroğlu TOBB University of Economics and Technology, Faculty of Medicine, Department of Orthopaedics and Traumatology, Ankara, Turkey

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Manuel Cassiano Neves CUF Descobertas Hospital, Department of Paediatric Orthopaedics, Lisbon, Portugal

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Cruz AI Jr . Increasing rates of surgical treatment for paediatric tibial shaft fractures: a national database study from between 2000 and 2012 . J Child Orthop 2019 ; 13 : 213 – 219 . 31. Stenroos A Laaksonen T

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Josep Muñoz Vives Hospital Nostra Senyora de Meritxell, Andorra, Spain

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Jean-Christophe Bel Hospices Civils de Lyon, Lyon, France

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Arantxa Capel Agundez Hospital Universitario 12 de Octubre, Madrid, Spain

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Francisco Chana Rodríguez Hospital General Universitario Gregorio Marañón, Madrid, Spain

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José Palomo Traver Hospital General de Castelló, Castelló de la Plana, Spain

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Morten Schultz-Larsen Odense Universitetshospita, Odense, Denmark

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Theodoros Tosounidis Leeds General Infirmary, Leeds, UK

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tibial shaft fracture and type II c) (9%) is a fracture of the tibia plateau and articular fracture of the distal femur. 2 Fig. 1 Fraser classification of the floating knee. Initial management The floating knee is much more than a

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Christos Garnavos Orthopaedic and Trauma Department, ‘Evangelismos’ General Hospital, Athens, Greece

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work is attributed. References 1. Lang GJ Cohen BE Bosse MJ Kellam JF . Proximal third tibial shaft fractures: should they be nailed? Clin Orthop Relat Res 1995 ; 315 : 64 – 74 . 2

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Jordi Tomás-Hernández Department of Orthopaedic and Trauma Surgery, Hospital Vall d’Hebron, Barcelona, Spain

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severe soft-tissue injuries, comminution and multiple displaced articular fragments. Conversely, rotational injuries are typically low-energy fractures with less soft-tissue injury and, usually, a distal tibial spiral fracture pattern. In this review, we

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Nuno Marques Luís Knee and Ankle Surgery, Arthroscopy and Sports Trauma Unit; Orthopedic Center, Hospital Cuf Descobertas, Lisbon, Portugal

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Ricardo Varatojo Knee and Ankle Surgery, Arthroscopy and Sports Trauma Unit; Orthopedic Center, Hospital Cuf Descobertas, Lisbon, Portugal

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weight-bearing X-rays, eventually causing imprecision in operative planning. 1 , 2 When standard weight-bearing X-rays are used to calculate alignment, the estimated angle on the X-ray is called the anatomic tibiofemoral angle or femoral-shaft–tibial-shaft

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