The treatment of malunion of tibial fractures in patients with traumatic brain injury

Brain injury is commonly associated with multiple trauma and extremity fractures. Often the extremity fractures are inadequately treated resulting in malunions with associated loss of function. We reviewed the cases of five young male patients with brain injury and malunited tibial fractures that required additional reconstructive surgery. Four patients required correction of bony angular deformities. One required extensive soft tissue releases. Two of the patients developed severe deformities of the ankle joint necessitating arthrodesis. One patient was left with Gem shortening and required bone lengthening using a ring fixator with bone transport. Musculoskeletal injuries in patients with brain injury should be treated aggressively with the expectation of eventual neurologic recovery.