The management of closed tibial shaft fractures

Tibial shaft fracture is the most common of long bone fractures. A wide range of complications accompanies the treatment even of closed tibial shaft fractures. Management of this injury should be concentrated in units with adequate facilities and knowledge of these fractures. The treatment may be accomplished either conservatively or surgically; selection of approach must be based on clinical and radiological examination. Also patient-related variables must be considered. Conservative treatment is justified for fractures with slight initial displacement. In such cases, closed functional bracing is to be recommended, Intramedullary locking nailing (IMLN) should be applied when closed reduction under anaesthesia is necessary to achieve an acceptable alignment. A subset of patients must be managed using either plate fixation or an external fixation device. (C) 2003 Elsevier Science Ltd. All rights reserved.