Functional bracing in the management of diaphysial fractures of Tibia

ABSTRACT

Tibia is the most commonly fractured long bone in the body, because its particular blood supply and high complications rate we always try to find out the best method to manage such fracture with minimal disturbance to its blood supply and early mobilizations. The fracture brace is one of the best methods of treatment of fractures regarding safety and early mobilization. We used the brace in closed and compound [Gustillo I and II] in adult, and shows its advantage over other methods regarding safety, mobility, and low complication rate. Nineteen patient with tibial shaft fracture was investigated during the treatment with tibial castbrace Fractures were classified according to AO/ASIF classification. Patients were treated primarily by back slab followed by plaster application from toes to above the knee Fracture brace was applied after the pain and swelling had subsided. Serial x-ray films were taken regularly in a fixed dates to observe and prevent any unacceptable misalignment cast brace was discarded after union, when it found safe to walk independently. The average time needed for application of the cast after injury was [4.8] weeks for closed fractures and [6.1] weeks for open Fractures. Union occurred in an average of [17.2] weeks for type A1 [AO/ASIF], [16.2] weeks for A2, and the longest healing time [22.2] weeks was obtained in type C. Neither a significant shortening was obtained with a range of [8.6-13.4 mm.] nor an angulations range of [1-7.5[°]] if compared with the acceptable figures. Functional bracing is another method in accomplishing the goal of early introduction of function after bone union. It does not replace other methods of treatment which have its specific indications. Functional bracing is successful in type A, and can be used in type B and C of AO/ASIF classification .The misalignments obtained are mostly within acceptable range if compared with the standard figures