A Review of Current Management of Distal Tibia Extraarticular Fractures

Sujan Raj Paudel^1*, Ankit Shrivastava² & Ram Kewal Shah³

¹Orthopaedic Surgeon, Scheer Memorial Adventist Hospital, Banepa, Nepal
²Orthopaedic surgeon, Janakpur Trauma Hospital, Janakpur, Nepal
³Head of Department, Department of Orthopaedics, Janaki Medical College, Janakpurdham, Nepal

Dr. Sujan Raj Paudel, Orthopaedic Surgeon, Scheer Memorial Adventist Hospital, Banepa, Nepal.

Keywords: Extraarticular Tibia Fractures; Distal Tibia Fractures; Nonunion of Tibia

Abstract

The treatment of distal tibia fractures is challenging. Various methods of treatment including plaster, traction, splints, external fixation and internal fixation methods like intramedullary nails or plates have been used to treat such fractures. The optimal treatment of unstable distal tibia fractures without articular involvement remains controversial. No any fixation method suits all fractures.
Nonunion of these fractures has profound impact on the patient’s physical and mental health. The cost of lost productivity is even more. It is very important to understand the fracture geometry before planning fixation. Stress concentration at the fracture site in simple (two part) fractures is prohibitive of bone formation. However, stress is distributed in comminuted fractures and the interfragmentary movement is minimal.
In recent literature, most distal tibial nonunion is attributed to instability. In distal tibial extraarticular fractures, the idea is absolute stability for simple fractures and relative stability for comminuted fractures. Implant selection should be guided by the stability required.

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