An analysis of Clinical Experience with Closed Tibia Fractures

An analysis of Clinical Experience with Closed Tibia Fractures

Orthopedic implants manufacturers and Delta Tibia / Femur Nailing System specialist in India. In this study, we will try to summarize clinical research performed on a group of 1000+ patients with closed fractures of the tibia treated with prefabricated braces at the Los Angeles County Institute of Southern California Medical Center. As mentioned further that due to some social and economic factors, the final evaluation of orthopedic implants and orthopedic instruments was possible in approximately 800 patients only. Another considerable factor was that seven nonunion were encountered (0.8%).

Also, seventeen orthopaedic implants and instruments like braces were removed or stopped in use because of shortening or for unacceptable angulation or because of skin complications. The method of injury that created these closed fractures indicated that some were sustained in vehicle-related accidents and the remaining had been caused by a direct blow over the extremity. On further analysis and insight of the extremities indicated that 35% of the patients had no shortening. The remaining shortening ranged from the range of 1-30 mm. This also implied that approximately 85% of the patients had shortening of less than 10 mm; in 8% shortening ranges somewhere between 1 and 15 mm, in other 3% between 16-20 mm, and in 0.5% between 21-30 mm.

The orthopedic implants manufacturers report further suggested that no angular deformity was measured in some of the patients. More than 90% healed their fractures with less than 8 or 8.2 angulation and few rare cases had angulation in 11°. The most observed deformity was of Varus. A total of 1.3% out of 700+ analyzed had angular deformities between 9° and 10° and few had varus angulation between 11° and15°. 

Also Read: –Shortening, Angulations, and Rotation in a Fracture

Other major findings as analyzed by our team of ortho surgical implants and trauma implants suggested that as per the report we can conclude that the degree of initial displacement of the fracture is somewhat claimed responsible for the speed of healing. This was observed on the fact that the fractures with less than 10 % displacement healed in an average of 15 weeks, those between 42% – 50%displacement in an average of 19.8 weeks, and those between 81° and 90° in an average of 23.3 weeks; while those higher healed in 20 weeks.


Going further, let’s analyze some other factors. Talking about the age, the age of these patients was in the range 22-54 years and the fractures in 18 patients were the result of a vehicular accidents. Fractures were categories in three grade I, grade II and grades III, and one exception caused by a gunshot wound. Eighteen ortho surgical implants fractures had an associated fibula fracture and most among these cases were initially treated by closed reduction and application of a long-leg cast. Remaining was treated with an external fixator or interlocking nails and locking plates. A fibular osteotomy (A surgical procedure for medial compartment knee osteoarthritis and is an alternative to high tibial osteotomy) was performed in two cases, one at 2 weeks with an intact fibula and one at 6 months in a patient with an oblique middle fracture and an associated fibular fracture which had already joined earlier.

Many braces (40+) were discontinued during treatment owing to progressive angulation or due to loss of corrected shortening. These cases of patients were advised to undergo an operation to correct their abnormality. Some others could not wear their brace due to exasperation of preexisting soft tissue wounds and were treated in a below-the-knee functional cast until joining of the bone. Out of these, some were unable to handle the functional brace. These patients were treated in a below-the-knee functional cast until union.

After the application of the prefabricated brace, 3% of them required manipulation of fractures which was performed with the patient flexing his leg over the rim of the examining table which was done under sedation. In these cases, the braces were temporarily discontinued for few weeks and long-leg casts were applied.

This was a brief analysis of the report. As the orthopedic implants manufacturers in India, we also suggest that bracing adjustments and contouring need to be performed only when necessary to ensure proper fitting.