JAAOS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

J Am Acad Orthop Surg, Vol 14, No 7, July 2006, 406-416.
© 2006 the American Academy of Orthopaedic Surgeons
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Bedi, A.
Right arrow Articles by Karunakar, M. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bedi, A.
Right arrow Articles by Karunakar, M. A.

Surgical Treatment of Nonarticular Distal Tibia Fractures

Asheesh Bedi, MD, T. Toan Le, MD and Madhav A. Karunakar, MD

Dr. Bedi is Resident Physician, Department of Orthopaedic Surgery, University of Michigan Medical Center, Ann Arbor, MI. Dr. Le is Assistant Professor, Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, University of Cincinnati, Cincinnati, OH. Dr. Karunakar is Assistant Professor, Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, University of Michigan Medical Center.

None of the following authors or the departments with which they are affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Bedi, Dr. Le, and Dr. Karunakar.

Reprint requests: Dr. Karunakar, Department of Orthopaedic Surgery, University of Michigan Medical Center, TC2914, 1500 E Medical Center Drive, Ann Arbor, MI 48109.

Distal tibia metaphyseal fractures can be difficult to manage. Treatment selection is influenced by the proximity of the fracture to the plafond, fracture displacement, comminution, and injury to the soft-tissue envelope. Nonsurgical management is possible for stable fractures with minimal shortening. Indications for intramedullary nailing have expanded to include distal metaphyseal tibia fractures. Intramedullary nailing allows atraumatic, closed stabilization while preserving the vascularity of the fracture site and integrity of the soft-tissue envelope. Intramedullary canal anatomy at this level prevents intimate contact between the nail and endosteum, however, and concerns have been raised regarding the biomechanical stability of fixation and risk of malunion. Plate fixation is effective in stabilizing distal tibia fractures. Conventional techniques involve extensive dissection and periosteal stripping, which increase the risk of soft-tissue complications. Percutaneous plating techniques use indirect reduction methods and allow stabilization of distal tibia fractures while preserving vascularity of the soft-tissue envelope. External fixation is effective in the setting of contaminated wounds or extensive soft-tissue injury. Careful preoperative planning with consideration for fracture pattern and soft-tissue condition helps guide implant selection and minimize postoperative complications.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2006 by the American Academy of Orthopaedic Surgeons.