Tibia Fractures with an Intact and Non Intact Fibula

In our years of experience as a leading orthopedic implants manufacturing company in India, we have seen approx 3 in every 4 cases of tibial fractures that have an associated fibular fracture. Those with no associated fibular fracture need special attention, primarily because of the advanced incidence of Varus angular deformities in this group.

This is a snag likely to be seen in cases of closed treatment no matter whether a brace is used or not. According to one of our recent orthopedic implants studies based on approx 100 tibial fractures without associated fibular fractures, it was found that fractures restored to health with an average Varus angulation of average 4° (10 – 120). In this set, fractures of the proximal and distal third of the tibia showed the maximum angulation which was in the range of 6.5°and 6°, respectively, while fractures of the middle third healed with an average of 3.9° of Varus. The reinforcement provided by the intact fibula against the sideways aspect of the proximal tibia inclined to the varus angulation. This angulation found in our ortho surgical implants studies was usually associated with an inner alternation irregularity which was caused by the more posterior location of the fibula about the tibia. Our Spine Implants experts suggested that while reducing the fractures the fact should be kept in mind is that the distal tibial fragment is rotated externally, hopefully in an attempt to diminish the deformity.

Separated fractures of the tibia that do not show initial angular deformity and has fewer chances to angulate more than those which at the time of initial injury demonstrate an angulation quotes another Spine Implants Suppliers head. In cases where distortion develops, consideration can be given to the performance of a fibular osteotomy (a kind of surgical operation whereby a bone is slashed to shorten or lengthen it or to change its alignment) carried out somewhat above or below the tibial fracture in order to ease the varus stress on the tibia.

Few scientists in the late 1980s had reported an increased incidence of osteoarthritis of the ankle in patients with healed isolated tibial fractures. Although, this has not been our experience. Recently, a few decades back scientists documented a lack of osteoarthritis in long-term follow-ups of malunited (united in a position of abnormality or deformity) diaphyseal fractures.

We are the leading Spine Implants Exporter too. The geometry of the fracture of the tibia in the nonexistence of a fibular fracture plays a vital role in determining whether angular deformities are to occur or not and, if it does, to what extent. The position of the fracture is significant as well. As we have stated above that the isolated tibial fracture is most likely to develop a varus deformity. This is probably due to the most posterior location of the fibula about the tibia and the maximum separation between the two bones, allowing for greater outer space of the displaced tibia. Typically, the displacement of the tibia should discontinue upon its support against the fibula as it limits the degree of varus deformity. However, there are instances though rare where the fibula is located very far to the point that the tibia can dangle in front of it without ever neighboring against it. Our ortho surgical implants suspect that such a condition is more likely to be found in patients with built-in varus and internal rotation of their tibias prior to the injury. In these cases, careful consideration must be given to the likely behavior of the fracture before deciding that either osteotomy (the surgical cutting of a bone generally done to allow realignment) or any other methods of fixation will be used.

Our orthopedic surgical instrument studies have also suggested that the direction of the tibial fracture also plays a major role. The isolated tilted fracture of the tibia is where the fracture line runs from medial to lateral will be subjected to a greater degree of angular deformity than a comparable fracture running from lateral to medial. In the former instance, the proximal fragment can displace into varus without ever touching against the distal tibial fragment. In the second instance, the proximal support structure against the distal fragment usually prevents further significant angulation.
In the case of the comminuted fracture, a sturdy base for support against the fragments that could prevent displacement is not possible.

Orthopedic implants and instruments expert also suggests that one should not estimate that every fracture of the tibia with an intact fibula makes functional bracing using AFN Nailing System or Multifix Tibia Nailing is impossible. In many cases, where no preliminary deformity is present and the location and structure of the fracture suggest steadiness, if bracing is followed by gradual enhancement of weight-bearing, deformities usually do not extend. If by any means angulation develops, it is usually negligible and therefore good enough.

In the Delta Tibia / Femur Nailing System business, we have noticed with interest that in fractures of the distal tibia with an unbroken fibula where reduction does not exist and the fracture pattern is in a slanted direction, the fracture line always looks like to be extended from lateral to medial, therefore depriving the distal fragment of the opportunity to abut against the longer and more stable proximal one.

Even though we have seen foremost angular deformities of fractures at the level of the orthopedic implant, the decree is that

angulation is of a smaller degree. Our orthopedic surgical instruments team expert suggests that this could perhaps

be explained by the fact that in the distal third of

the leg area, the tibia is very close to the fibula and the latter is closer to the same axis of alignment of the tibia, preventing displacement of the tibial fragments without abutment against the fibula. The comminuted fracture (a break or fall apart of the bone into more than two fragments) at this orthopedic implants level produced by gunshot wound is frequently associated with the unacceptable angular deformity. In this case, an appropriate measure must be taken to prevent such complications.

It is equally important that the authenticity of talocalcaneal motion must be present in order to accept more than just a few degrees of varus or valgus deformity, claims humerus Interlocking Nailing expert. Also, such assessment is tricky to conduct during the sensitive stages, hence it is appropriate to rely on an examination of the opposite extremity in a hope that the level of motion of the subtalar joint on the pretentious side is equal to the usual part.