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March 28, 1966

Tibial-Shaft Fractures in Adults and Children

Author Affiliations

From the Department of Surgery, Section of Orthopedics, University of Michigan Medical School, Ann Arbor, and Wayne County General Hospital, Eloise, Mich. Dr. Stanford is now at the University of Oregon Medical School, Portland. Dr. Rodriguez is presently at Tulane University School of Medicine, New Orleans.

JAMA. 1966;195(13):1111-1114. doi:10.1001/jama.1966.03100130085022

Healing rates of various types of tibial-shaft fractures are compared as to type of treatment. Conservative management in adults is found to have certain advantages and certain limitations. In the case of closed tibial-shaft fractures, no advantage is shown for either open operative or closed treatment. The hazard of introducing infection is considered to be the single greatest deterrent to operative fixation of closed fractures. In this series, primary internal fixation of an open fracture is associated with a very real hazard of infection and with prolongation of the healing rate. Internal fixation of open tibial-shaft fractures should be reserved for those cases with minimal contamination and cases in which stability can be achieved with the least exposure of bone and the least quantity of metal implanted in the limb.