Complications in the treatment of Segmental tibial fractures

Abstract

Segmental tibial fractures belong to the group of the most severe fractures of the locomotor system. They are most common in polytraumatized patients. Treatment of segmental tibial fractures can be conservative or operative. Treatment of segmental tibial fractures is accompanied by a number of complications, such as delayed healing, dislocation of fragments in one or the other fracture point, healing of fractures in poor position, non-healing of fractures, aseptic and septic pseudoarthrosis, infection around fixator wedges, wound infection of open segmental tibial fracture, iatrogenic infection, osteomyelitis, and limb amputation. The paper presents a female patient with a severe segmental tibial fracture on two levels, who was treated with external skeletal fixation. Without opening the fracture point, repositioning was performed in the proximal and distal part and the fractures were stabilized with an external skeletal fixator. After the operation, the patient was activated with underarm crutches with relief support on the injured leg. For the purpose of stimulating fracture healing, low molecular weight heparin, Fraxiparine (to prevent thrombosis and pulmonary thromboembolism) and Forticolinn were prescribed. After the fracture healed, the external skeletal fixator was removed and the patient returned to her working and living activities. At the follow-up examination five years after the segmental tibial fracture, the patient had a stable and firm support on the injured leg.