Open tibial shaft fracture fixation strategies: intramedullary nailing, external fixation, and plating

Abstract

Tibial shaft fractures are one of the most common orthopaedic injuries. Open tibial shaft fractures are relatively common because of the paucity of soft tissue surrounding the bone. Despite the prevalence of these injuries, the optimal fixation strategy is still a topic of debate. The purpose of this article was to review the current literature on open tibial shaft fracture fixation strategies including intramedullary nailing, external fixation, and plating.

Keywords: open fractures; outcomes; review article; tibia; trauma.

Figure 1.

Open tibia shaft fracture. Initial injury x-ray, clinical photograph, and postoperative x-rays after intramedullary nailing. These are the authors' original photographs and x-rays.

Figure 2.

Provisional plating: intraoperative photograph before the plate was removed. This figure is being reprinted from Ref. under the terms of the Creative Commons license (CC-BY).

Figure 3.

Clinical photographs of a uniplanar external fixator. This figure is being reprinted from Ref. under the terms of the Creative Commons license (CC-BY).

Figure 4.

Clinical photographs of a ring external fixator. This figure is being reprinted from Ref. under the terms of the Creative Commons license (CC-BY).

Figure 5.

A and B, Initial injury x-ray and clinical photograph of a 53-year-old male patient who sustained an open proximal tibial fracture. C and D, Postoperative x-ray and clinical photograph after minimally invasive plate osteosynthesis and rotational gastrocnemius muscle flap. This figure is being reprinted from Ref. under the terms of the Creative Commons license (CC-BY).