Poor retention after closed reduction and cast immobilization of low-energy tibial shaft spiral fractures.
BACKGROUND AND AIMS: The aim of this retrospective study was to analyze retention in cast after closed reduction of low-energy two-fragment tibial shaft fractures. MATERIAL AND METHODS: The material consisted of 72 closed tibial shaft fractures AO/ ASIF type A treated with closed reduction and plaster cast. Fractures were subgrouped according to the AO/ASIF classification and the initial fracture displacement was measured. Final alignment and the frequency of operative intervention due to early loss of reduction were analyzed. RESULTS: 40% of all fractures lost reduction and were operated on. The largest subgroup was A1.2 fractures, a spiral tibial shaft fracture with a fibular fracture at another level. Out of the 28 fractures in this group 61% were converted from cast to early operative intervention. CONCLUSION: Closed reduction and cast treatment of spiral tibial shaft fractures AO/ ASIF type A1.2 had a high failure rate.