Compression plating of tibial fractures following primary external fixation

During the time period from May 1990 to December 1992, a total of 75 tibia fractures were treated in the Department of Traumatology at the University of Bonn. Thirtyeight patients with 40 tibial fractures were managed according to a regimen including primary stabilization, usually using external fixation, soft tissue reconstruction and delayed open reduction and internal fixation using an AO compression plate. The majority of the patients had been involved in motor vehicle accidents, leading to multiple injuries in 24 instances. An open fracture was seen 18 times. The 20% complication rate is comparable to the reports following intramedullary stabilization. Only one infection, following a grade 2 open fracture, was seen after the definitive stabilization. Bony union was achieved after 15.7 weeks. In light of the complications associated with intramedullary nailing, such as fat or air embolism, heterotopic ossification and non- or malunions, use of the tibial plate does not offer just logistic advantages, but is a viable alternative for delayed stabilization of tibial fractures.