A Demographic Study of Non-Union Rate of Isolated Tibia Shaft Fracture with Intact Fibula in a Single Centre
Introduction: Isolated tibia shaft fracture with intact fibula is known to be difficult to treat, often complicated with malunion, delayed or even non-union. The intact fibula is often blamed in these problems as it will interfere with the bone healing by preventing effective compression at the...
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2020
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RD Surgery RZ Other systems of medicine Vernon Sze Yuen, Tan A Demographic Study of Non-Union Rate of Isolated Tibia Shaft Fracture with Intact Fibula in a Single Centre |
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Introduction:
Isolated tibia shaft fracture with intact fibula is known to be difficult to treat, often complicated with malunion, delayed or even non-union. The intact fibula is often blamed in these problems as it will interfere with the bone healing by preventing effective compression at the fracture site. Management of such cases is still matter of debate to date.
International literatures stated the non-union rates related to this type of fracture range from 1%-17%. However, a demographic study was never done in our population. Therefore, we would like to study the union rate of isolated tibia shaft fracture with intact fibula in our population and compare the similarities with those literatures available. Our hypothesis is isolated tibia shaft fracture with intact fibula will have high non-union rate if treated conservatively compared to operative treatment in our population.
Our primary objective of this study is to study the non-union rate of isolated tibia shaft fracture with intact fibula in Sarawak General Hospital.
Result:
A total of 80 patients were recruited in this study, with the mean age of 33.75 ± 12.2 (range from 16 - 63 years old). Most of the patients were male (N=60) compare to female (N=20). There are divided into 2 groups: conservative treatment group (N=40) and operative group (N=40). For conservative group, the non-union rate was 15% at 6 months post invervention, while for the operative group, the non-union rate was 7.5%. Howevere, these results were not statistically significant. There was no significant correlation in term of types of management and the non-union rate in isolated tibia shaft fracture noted in our study.
Conclusion:
Our study showed there was no significant correlation between the treatment modalities and union outcome in patients with isolated tibia shaft fracture with intact fibula. |
| format |
Thesis |
| qualification_level |
Master's degree |
| author |
Vernon Sze Yuen, Tan |
| author_facet |
Vernon Sze Yuen, Tan |
| author_sort |
Vernon Sze Yuen, Tan |
| title |
A Demographic Study of Non-Union Rate of Isolated Tibia Shaft Fracture with Intact Fibula in a Single Centre |
| title_short |
A Demographic Study of Non-Union Rate of Isolated Tibia Shaft Fracture with Intact Fibula in a Single Centre |
| title_full |
A Demographic Study of Non-Union Rate of Isolated Tibia Shaft Fracture with Intact Fibula in a Single Centre |
| title_fullStr |
A Demographic Study of Non-Union Rate of Isolated Tibia Shaft Fracture with Intact Fibula in a Single Centre |
| title_full_unstemmed |
A Demographic Study of Non-Union Rate of Isolated Tibia Shaft Fracture with Intact Fibula in a Single Centre |
| title_sort |
demographic study of non-union rate of isolated tibia shaft fracture with intact fibula in a single centre |
| granting_institution |
University Malaysia Sarawak |
| granting_department |
Department of Orthopaedics |
| publishDate |
2020 |
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http://ir.unimas.my/id/eprint/37471/2/VERNON%20TAN%20SZE%20YUEN.pdf |
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my-unimas-ir.374712023-05-11T09:15:45Z A Demographic Study of Non-Union Rate of Isolated Tibia Shaft Fracture with Intact Fibula in a Single Centre 2020-12-01 Vernon Sze Yuen, Tan RD Surgery RZ Other systems of medicine Introduction: Isolated tibia shaft fracture with intact fibula is known to be difficult to treat, often complicated with malunion, delayed or even non-union. The intact fibula is often blamed in these problems as it will interfere with the bone healing by preventing effective compression at the fracture site. Management of such cases is still matter of debate to date. International literatures stated the non-union rates related to this type of fracture range from 1%-17%. However, a demographic study was never done in our population. Therefore, we would like to study the union rate of isolated tibia shaft fracture with intact fibula in our population and compare the similarities with those literatures available. Our hypothesis is isolated tibia shaft fracture with intact fibula will have high non-union rate if treated conservatively compared to operative treatment in our population. Our primary objective of this study is to study the non-union rate of isolated tibia shaft fracture with intact fibula in Sarawak General Hospital. Result: A total of 80 patients were recruited in this study, with the mean age of 33.75 ± 12.2 (range from 16 - 63 years old). Most of the patients were male (N=60) compare to female (N=20). There are divided into 2 groups: conservative treatment group (N=40) and operative group (N=40). For conservative group, the non-union rate was 15% at 6 months post invervention, while for the operative group, the non-union rate was 7.5%. Howevere, these results were not statistically significant. There was no significant correlation in term of types of management and the non-union rate in isolated tibia shaft fracture noted in our study. Conclusion: Our study showed there was no significant correlation between the treatment modalities and union outcome in patients with isolated tibia shaft fracture with intact fibula. Universiti Malaysia Sarawak (UNIMAS) 2020-12 Thesis http://ir.unimas.my/id/eprint/37471/ http://ir.unimas.my/id/eprint/37471/2/VERNON%20TAN%20SZE%20YUEN.pdf text en validuser masters University Malaysia Sarawak Department of Orthopaedics REFERENCES 1. Dailey HL, Wu KA, Wu PS, McQueen MM, Court-Brown CM. Tibial Fracture Nonunion and Time to Healing After Reamed Intramedullary Nailing: Risk Factors Based on a Single-Center Review of 1003 Patients. J Orthop Trauma. 2018 Jul;32(7):e263-e269 2. Teitz CC, Carter DR, Frankel VH. Problems associated with tibial fractures with intact fibulae. J Bone Joint Surg Am. 1980; 62:770-6 3. Jorgensen TE. The influence of the intact fibula on the compression of a tibial fracture or pseudoarthrosis. Acta Orthop Scand. 1974; 45:119-29. 4. Bone LB, Sucato D, Stegemann PM, Rohrbacher BJ. Displaced isolated fractures of the tibial shaft treated with either a cast or intramedullary nailing. An outcomeanalysis of matched pairs of patients. J Bone Joint Surg Am. 1997; 79:1336-41. 5. O’Dwyer KJ, DeVriese L, Feys H, Vercruysse L. Tibial shaft fractures with an intact fibula. Injury. 1993; 24:591- 4. 6. Leach RE. Fractures of the tibia and fibula. In: Rockwood CA, Green DP (eds). Fractures in Adults, Philadelphia: JB. Lippincott Co, Ch. 1984; 2:17. 7. Hooper, G., Buxton, R. A. and Gillespie, W. J. 1981. Isolated fractures of the shaft of the tibia. Injury 12, 283–289. 8. Balaji S M, Chandra P M, Devadoss S, Devadoss A. The effect of intact fibula on functional outcome of reamed intramedullary interlocking nail in open and closed isolated tibial shaft fractures: A prospective study. Indian J Orthop 2016;50:201-5 9. McGee, H.M.J., Casserley, H. & Kelly, J.M. The complications of isolated tibial fractures. I.J.M.S. 153, 208–213 (1984). https://doi.org/10.1007/BF02943601 10. Abouchane M, Fadili A, Belmoubarik A, El Andaloussi Y, Nechad M. [Leg fractures with intact fibula: casting or intramedullary nailing? (comparative study of 60 cases)]. The Pan African Medical Journal. 2015;20:222. DOI: 10.11604/pamj.2015.20.222.6164. 11. M. Bhandari, G. H. Guyatt, M. F. Swiontkowski, P. Tornetta III, S. Srpague, and E. H. Schemitsch, “A lack of consensus in the assessment of fracture healing among orthopaedic surgeons,” Journal of Orthopaedic Trauma, vol. 16, no. 8, pp. 562–566, 2002. 12. Nicoll E. A. (1964) Fractures of the tibia1 shaft. J Bane joint Strrg. 46B, 373. 13. Hoaglund F. and States J. (1967) Factors influencing the rate of healing in tibia1shaftfractures.Surg. Gymcol Obsfet. 124, 770. 14. Sarmiento A. (1967) A functional below-the-knee cast for tibia1fractures. 1. Bone]oinf Surg. 49A, 855. 15. Teitz C., Carter D. and Frankel V. (1980)Tibia1 fractures with intact fibulae. J. Bone joint Surg. 62A, 770. 16. Bonnevialle P, Bellumore Y, Foucras L, Hézard L, Mansat M. Tibial fracture with intact fibula treated by reamed nailing. Rev Chir Orthop Reparatrice Appar Mot. 2000; 86:29-37. |