M.E.Müller: Atlas: Fracture 42-A2

Tibia/Fibula, Diaphysis,
simple fracture, oblique ( >=30º )
1,46% of the total
7,50% of the tibia
13,46% of the segment

162 fractures
20,5% group
77%M, 23%F

306 fractures
38,7% group
75%M, 25%F

323 fractures
40,8% group
73%M, 27%F

Fibula intact +Q Fibula fractured at another level +Q Fibula fractured at the same level +Q

These are simple diaphyseal fractures of the tibia, with an oblique fracture line, located at whatever level of the diaphysis of the tibia. An oblique fracture line is defined by its inclination equal to or greater than 30º with respect to the perpendicular to the axis of the tibia. The characteristic that differentiates the subgroups is whether or not there is an associated fracture of the fibula and its location in relationship to the level of the fracture of the tibia. In the .1 subgroup, the fibula is intact. Ref. Manual of Internal Fixation:
332 - 364. 106 - 117 (2ª ed.).
Surgeon. RO.

Non-interlocked, reamed intramedullary nailing is the surgical technique indicated for the fractures of this group located at the middle third of the diaphysis, whatever the status of the fibula. The broad contact of the nail with the inner surface of the proximal and distal fragments guarantees the reduction, stability and dynamic axial compression under loading. The case is different in the proximal and distal fractures because the nail will not give enough support to one of the fragments; If a nail is to be used, it will have to be interlocked either proximally or distally.

Another treatment possibility is the open anatomic reduction, interfragmentary compression with a lag screw and protection (neutralization) of the fracture site with a plate, properly contoured in order for it to be prestressed and to function as a buttress. In the proximal fractures it is sometimes necessary to use double plating.

preoperative preoperative

postoperative postoperative + 4 months + 4 months




						Tibia/Fibula, Diaphysis, simple fracture, oblique ( >=30º )	1,46% of the total 7,50% of the tibia 13,46% of the segment






These are simple diaphyseal fractures of the tibia, with an oblique fracture line, located at whatever level of the diaphysis of the tibia. An oblique fracture line is defined by its inclination equal to or greater than 30º with respect to the perpendicular to the axis of the tibia. The characteristic that differentiates the subgroups is whether or not there is an associated fracture of the fibula and its location in relationship to the level of the fracture of the tibia. In the .1 subgroup, the fibula is intact.		Ref. Manual of Internal Fixation: 332 - 364. 106 - 117 (2ª ed.). Surgeon. RO.

Non-interlocked, reamed intramedullary nailing is the surgical technique indicated for the fractures of this group located at the middle third of the diaphysis, whatever the status of the fibula. The broad contact of the nail with the inner surface of the proximal and distal fragments guarantees the reduction, stability and dynamic axial compression under loading. The case is different in the proximal and distal fractures because the nail will not give enough support to one of the fragments; If a nail is to be used, it will have to be interlocked either proximally or distally.	Another treatment possibility is the open anatomic reduction, interfragmentary compression with a lag screw and protection (neutralization) of the fracture site with a plate, properly contoured in order for it to be prestressed and to function as a buttress. In the proximal fractures it is sometimes necessary to use double plating.