JBJS | Avoiding Complications in the Care of Fractures of the Tibia

The Journal of Bone & Joint Surgery, Volume 90, Issue 8

Selected Instructional Course Lecture | August 01, 2008

Avoiding Complications in the Care of Fractures of the Tibia

Lisa K. Cannada, MD¹; Jeffrey O. Anglen, MD²; Michael T. Archdeacon, MD, MSE³; Dolfi HerscoviciJr., DO⁴; Robert F. Ostrum, MD⁵

¹ Department of Orthopedic Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-8883. E-mail address: lisa.cannada@utsouthwestern.edu
² Department of Orthopaedics, Indiana University School of Medicine, 541 Clinical Drive, Suite 600, Indianapolis, IN 46202-5111
³ Department of Orthopaedics, University of Cincinnati Medical Center, P.O. Box 670212, 231 Albert Sabin Way, ML 0212, Cincinnati, OH 45267
⁴ Florida Orthopaedic Institute, 13020 Telecom Parkway North, Temple Terrace, FL 33673
⁵ 3 Cooper Plaza, Suite 408, Camden, NJ 08103

The Journal of Bone & Joint Surgery. 2008; 90:1760-1768

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Look for this and other related articles in Instructional Course Lectures, Volume 58, which will be published by the American Academy of Orthopaedic Surgeons in February 2009:"Prevention of Complications After Treatment of Femoral Shaft and Distal Femoral Fractures," by Robert F. Ostrum, MD, Jeffrey O. Anglen, MD, Michael T. Archdeacon, MD, MSE, Lisa K. Cannada, MD, and Dolfi Herscovici, DOTibial fractures are the most common long-bone fractures, with the National Center for Health Statistics reporting an annual incidence of 492,000 fractures of the tibia and fibula per year in the United States¹. Fractures of the tibial shaft range from low-energy minimally displaced fractures to limb-threatening injuries with associated nerve and arterial damage and major damage to the soft-tissue envelope. Even the lower-energy tibial shaft fractures are not as benign as they seem. Common problems include deformity after intramedullary nail fixation of fractures in the proximal one-third of the tibia, infections after open fractures, and aseptic nonunions. This lecture covers these three common complications, with an emphasis on prevention, recognition, and treatment.

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Topics

fracture ; tibia ; infection ; tibial fractures ; bone nails

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Accreditation Statement

These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.

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