SEVERE TIBIAL BONE FRACTURES

What is an open tibial shaft fracture?

The tibia refers to your shin bone in the lower leg. Open tells us the bone has fractured severely enough to come through the muscle and fascia and out through the skin. With an injury this severe, the jagged edges of the broken bone can cut the soft tissues, nerves, and/or blood vessels causing serious problems

Of course, surgery is required but the best way to approach injuries of this magnitude is not always obvious. There are concerns for protecting the soft tissues from further damage and concerns about the high rates of infection from the open wound. With so much bone damage, there's a risk of bone loss and limb shortening. Restoring stability, mobility, and function are the goals of immediate and long-term treatment.

The authors of this second part cover each aspect of the challenging treatment for these patients. Topics include fixation (ways to hold the bones together until healing occurs), orthobiologics (use of growth factors to speed up healing), limb salvage(saving the leg), and soft-tissue reconstruction. Amputation is also discussed as an option. Of course, everything is done to avoid removing the leg. But there are times when saving the leg as a functioning unit just isn't possible.

Although surgeons will benefit from the detailed discussion of each of these topics, patients and family members who are dealing with open tibial shaft fractures will be searching for information and answers they might find here. In the past, metal plates and screws were used to hold the broken pieces of bone together until healing took place. Fixation could also be done using external devices (outside the leg) with pins through the bone and a frame outside the leg.