M.E.Müller: Atlas: Fracture 42-A3

Tibia/Fibula, Diaphysis,
simple fracture, transverse ( < 30º )
1,54% of the total
7,95% of the tibia
14,26% of the segment

175 fractures
20,9% group
85%M, 15%F

285 fractures
34,0% group
85%M, 15%F

378 fractures
45,1% group
77%M, 23%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 a transverse fracture line (<30º), located at any level of the tibial diaphysis. These fractures are considered more serious than the A2 group fractures because, once reduced, there is less contact surface at the fracture site. The characteristic that differentiates the subgroups is whether or not there is an associated fracture of the fibula and its level relative to the fracture of the tibia. Ref. Manual of Internal Fixation:
332 - 364.
Surgeon. RO, LO.

The fractures of this group located at the middle third of the diaphysis, whatever the status of the fibula, are the ideal indication for reamed intramedullary nailing, non-interlocked. The fibula is a very important stabilizing element and, when intact, it should never be osteotomized in order to favour the dynamic compression of the tibia.

In order to prevent rotation of the distal fragment, the distal diaphyseal fractures should only be interlocked distally. The proximal fractures, close to the metaphyseal area, should only be interlocked proximally. The interlocking is allways efficaceous in preventing rotation, opposite to what happens when it is required to neutralize repeated compression forces which, because of the shear loading, may frequently result in screw breakage.

preoperative postoperative + 1 year + 1 year

preoperative postoperative + 1 year + 1 year

preoperative postoperative + 0 month

+ 1 year + 1 year




						Tibia/Fibula, Diaphysis, simple fracture, transverse ( < 30º )	1,54% of the total 7,95% of the tibia 14,26% of the segment






These are simple diaphyseal fractures of the tibia with a transverse fracture line (<30º), located at any level of the tibial diaphysis. These fractures are considered more serious than the A2 group fractures because, once reduced, there is less contact surface at the fracture site. The characteristic that differentiates the subgroups is whether or not there is an associated fracture of the fibula and its level relative to the fracture of the tibia.		Ref. Manual of Internal Fixation: 332 - 364. Surgeon. RO, LO.

The fractures of this group located at the middle third of the diaphysis, whatever the status of the fibula, are the ideal indication for reamed intramedullary nailing, non-interlocked. The fibula is a very important stabilizing element and, when intact, it should never be osteotomized in order to favour the dynamic compression of the tibia.	In order to prevent rotation of the distal fragment, the distal diaphyseal fractures should only be interlocked distally. The proximal fractures, close to the metaphyseal area, should only be interlocked proximally. The interlocking is allways efficaceous in preventing rotation, opposite to what happens when it is required to neutralize repeated compression forces which, because of the shear loading, may frequently result in screw breakage.