English summary: RESULTS OF OPERATIVE TREATMENT OF TIBIAL FRACTURES AT KUOPIO UNIVERSITY HOSPITAL IN 2001-2003

Background Tibial shaft fracture is a serious injury associated with a high complication rate and significant morbidity. The purpose of this study was to evaluate the treatment results and outcome of operatively treated patients at Kuopio University Hospital in 2001-2003.

Methods Eighty-one adult patients with tibial shaft fractures were operated on at Kuopio University Hospital in the period 2001-2003. Patients' case records and radiographs were examined and analysed. Sufficient information was available from 63 patients.

Results The mean age of patients was 43 (14-77) years and median follow-up time was 38 (30-48) months. There were 19 open and 44 closed fractures. 23 were caused by high-energy trauma. 54 were treated by intramedullary nailing, 6 by external fixation and 3 by plate fixation. 41% of patients with closed and 57% with open fractures were operated on within the recommended time-limits. Median time to fracture union was 12 (12-65) weeks and mean duration of incapacity for work was 21 weeks. Reoperation was required for 16 patients (24%) and 20 patients (32%) had complications including 9 superficial and 4 deep infections, 6 compartment syndromes, 3 malunions, 1 non-union, 1 DVT and three other complications. There was 1 patient with CRPS I and 6 patients complained of knee or ankle pain at the end of the follow-up time. Two patients had to be pensioned off because of the fracture.

Conclusions Our complication and reoperation rates were similar to those of previously published surgical series. There were no major differences in treatment strategies compared to Current Care guidelines. However, the recommended preoperative time-limits were not met in all cases and hospital policies thus need revising.