Tibia and fibula, shaft

10.1055/b-0034-87654

Tibia and fibula, shaft

Classification

The Müller AO Classification 510

Introduction

20.1 Tibia and fibula, shaft—introduction Rodrigo Pesantez, Fernando García, Chang-Wug Oh 511
1 Introduction 511
1.1 Incidence 511
1.2 Current methods of treatment 511
1.3 Indications and contraindications for MIPO 512
2 Surgical anatomy 513
2.1 Blood supply of the tibial shaft 513
2.2 Structures at risk 514
2.3 Preoperative assessment 515
3 Operating room setup 515
3.1 Anesthesia 515
3.2 Patient and image intensifier positioning 515
3.3 Instruments and implants 516
4 Preoperative planning 517
5 Operative procedure 517
5.1 Surgical approach 517
5.2 Medial approach 517
5.3 Lateral approach 518
6 Postoperative care 519
7 Pitfalls 520
8 Pearls 521
9 References 522

Cases

20.2 Extraarticular, bifocal closed fracture—42-A1, and articular trimaleolar ankle fracture—44-C2.3 (closed transverse fracture of the medial malleolus, lateral malleolus, and posterior malleolus) Fernando García 523
20.3 Tibia and fibula, shaft: simple fracture, transverse—42-A3 Chang-Wug Oh 529
20.4 Tibia and fibula, shaft: wedge fracture, spiral wedge—42-B1 Chang-Wug Oh 535
20.5 Tibia and fibula, shaft: complex fracture—42-C3 Chang-Wug Oh 541

Classification

According to the Müller AO Classification the tibial shaft is identified by the number 42. In the tibial shaft the fractures are either simple fractures (type A) or multifragmentary fractures. Multifragmentary fractures are divided into wedge (type B) and complex (type C) fractures. Minimally invasive plate osteosynthesis technique is ideally suited for 42-B and 42-C fractures when an intramedullary nail is contraindicated. Tibial shaft fractures may be open or closed and are often associated with severe soft-tissue injuries, therefore consideration of the severity of the wound and soft-tissue damage is important when treating open tibial fractures by MIPO techniques.