M.E.Müller: Atlas: Fracture 42-B1

Tibia/Fibula, Diaphysis,
wedge fracture, spiral wedge
1,63% of the total
8,38% of the tibia
15,04% of the segment

248 fractures
28,1% group
62%M, 38%F

427 fractures
48,3% group
58%M, 42%F

209 fractures
23,6% group
56%M, 44%F

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

These are multifragmentary diaphyseal fractures of the tibia with a spiral wedge third fragment that, once reduced, maintains contact between the proximal and distal fragments. In the .2 subgroup the fibula is fractured at another level; In the .3 subgroup the fibula is fractured at the same level, causing greater instability; In the .1 subgroup the fibula is intact. Ref. Manual of Internal Fixation:
200 - 207. 232 - 251. 574 - 587.
Surgeon. RO, RO.

Once the fracture is reduced, there is a broad contact surface between the intermediate fragment and the two main fragments. Interfragmentary compression between the intermediate fragment and the other two must be performed with lag screws and protected with a long plate that transfers the loads directly from the proximal to the distal fragment.

The plate will have to be exquisitely contoured for its adaptation to the cortical shape in all planes. It is preferably placed in the antero-medial aspect of the tibia because of its easier access. There is no biomechanical function difference if the plate is placed in the lateral or in the posterior aspect of the tibia because, during walking, the traction forces change and are distributed among the three aspects of the tibia. Added axial compression is obtained by placing the screws centripetally from the fracture site and using the excentricity of the DCP holes.

preoperative preoperative planning

+ 6 month + 6 month

preoperative postoperative + 1 year + 3 year

preoperative preoperative + 1 month + 1 month

+ 3 month + 3 month + 1 year + 1 year

preoperative postoperative + 1 year + 3 year

preoperative preoperative + 0 month + 0 month

+ 3 month + 3 month + 0 month + 0 month

preoperative postoperative + 3 month + 1 year




						Tibia/Fibula, Diaphysis, wedge fracture, spiral wedge	1,63% of the total 8,38% of the tibia 15,04% of the segment






These are multifragmentary diaphyseal fractures of the tibia with a spiral wedge third fragment that, once reduced, maintains contact between the proximal and distal fragments. In the .2 subgroup the fibula is fractured at another level; In the .3 subgroup the fibula is fractured at the same level, causing greater instability; In the .1 subgroup the fibula is intact.		Ref. Manual of Internal Fixation: 200 - 207. 232 - 251. 574 - 587. Surgeon. RO, RO.

Once the fracture is reduced, there is a broad contact surface between the intermediate fragment and the two main fragments. Interfragmentary compression between the intermediate fragment and the other two must be performed with lag screws and protected with a long plate that transfers the loads directly from the proximal to the distal fragment.	The plate will have to be exquisitely contoured for its adaptation to the cortical shape in all planes. It is preferably placed in the antero-medial aspect of the tibia because of its easier access. There is no biomechanical function difference if the plate is placed in the lateral or in the posterior aspect of the tibia because, during walking, the traction forces change and are distributed among the three aspects of the tibia. Added axial compression is obtained by placing the screws centripetally from the fracture site and using the excentricity of the DCP holes.