Minimal Fixations for Treatment of Closed Segmental Fractures of Tibial Shaft in Adults

Objective: Aim of the study is to evaluate the union rate, alignment and infection rate in treatment of closed segmental fractures of tibial shaft in adult by minimal fixations (internal and external). Patients and Methods: From April 2009 to January 2014, we treated 91 patients with high-energy fractures of the tibial shaft at Orthopedic Department of AlRamadi Teaching Hospital. Twenty patients were suitable for our study that had closed segmental fractures of tibial shaft (42-C2 / AO classification), treated by minimal, internal and external, fixations with follow up range from 6 months to 1 year. Results: The union rate was 85% with the expected time 12-24 weeks, 10% pass to delayed union and take average of 4 weeks more than the expected date; only 5% developed non-union and need bone graft to enhance union. The ranges of varus-valgus angulation were 0o-4o, while posterior-anterior angulation were 0o-3o. Six patients developed superficial pin tract infection and responded well to antibiotic therapy and local hygiene. No patient developed full picture of osteomyelitis, or deep infection. Conclusion: Because of high rate of success and less invasive surgery, we concluded that using the minimal fixations (internal and external) in the treatment of closed segmental fractures of tibial shaft (42-C2) in adults is a good choice alternative to locked intramedullary nail fixation.