Segmental Tibial Fractures: An Infrequent but Demanding Injury

Martin Teraa, Taco J. Blokhuis, Lisa Tang, Loek P. H. Leenen

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background
Segmental tibial fractures are considered to be a special injury type associated with high complication rates. However, it is unclear whether healing of these fractures truly differs from that of nonsegmental fractures.

Questions/purposes
We therefore asked (1) does the time to union in segmental tibial fractures differ from that of nonsegmental fractures; and (2) does the complication rate of segmental fractures differ from that of nonsegmental fractures?

Methods
We retrospectively studied 30 patients with segmental tibial fractures treated at a Level I trauma center from January 2000 to December 2008 and compared healing and complications with a matched control group of 30 nonsegmental tibial fractures. In followup we determined time to union, delayed and nonunion, and overall complication rates. Patients were followed at least until union was attained. The minimum followup was 5 months (median, 15 months; range, 5-54 months).

Results
Median time to union was 34 weeks (range, 12-122 weeks). Segmental fractures took longer to heal than nonsegmental fractures (median, 34 weeks; range, 12-122 weeks and median, 24 weeks; range, 11-39 weeks, respectively). The overall rate of complications was higher in segmental fractures as was the necessity for reoperation to attain healing.

Conclusions
Healing of segmental tibial fractures is characterized by substantially more complications and longer healing times than nonsegmental fractures and should be considered as a special type of injury. We believe these should be treated in specialized trauma centers.
Original languageEnglish
Pages (from-to)2790-2796
JournalClinical Orthopaedics and Related Research
Volume471
Issue number9
DOIs
Publication statusPublished - Sept 2013

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