![tibia and fibula fracture tibia and fibula fracture](https://i0.wp.com/teachmeorthopedics.info/wp-content/uploads/2020/04/C25-FF21-1.jpg)
The current application of generic guidelines appears suitable in the elderly, particularly in the acute management. Our data suggest that age and co-morbidities should not prohibit lower limb reconstruction. There was no difference in time to antibiotics, operative approach or post-operative complications.ĭespite the low-energy nature of elderly patients’ injuries, the severity of soft tissue insult was equivalent to younger patients with high-energy injuries. Elderly patients waited longer until debridement (21:19 vs 19:00 h) and had longer inpatient stays (23 vs 15 days). In cases where the fracture is mild and the bones are not out of alignment then conservative approaches in the form of case immobilization for a period of four to six weeks is done to allow the closed tibia or fibula fracture to heal. Most were Gustilo-Anderson IIIb in both age groups. Closed Tibia or Fibula Fracture can be treated with both conservative as well as surgical approaches. High-energy injuries were commoner in younger patients (88% vs 37% p<0.001).
Tibia and fibula fracture free#
An extended cohort examined free flap reconstruction. In this retrospective single centre cohort study (December 2015–July 2018), we compared the injury characteristics, operative management and outcomes of elderly (≥65 years) and younger (18–65 years) patients with open tibia/fibula fractures. This may have implications for future guidelines and verify their application in the elderly. The aim of this study was to determine if elderly patients are sustaining a different injury to younger patients and how their treatment and outcomes differ. There is conflicting evidence regarding whether older age affects treatment provision and outcomes in open fractures. Nonetheless, a higher index of suspicion may avoid unnecessary investigations and treatments.The incidence of open tibia/fibula fractures in the elderly is increasing, but current national guidelines focus on the aggressive treatment of high-energy injuries in younger patients. Despite a frequent delay in diagnosis, they have a good prognosis with conservative management. They usually occur in patients with underlying rheumatic diseases, mainly RA, and are frequently mistaken for other joint and bone conditions. IF of the tibia and fibula are probably more common than previously thought. The high frequency of IF seen in RA patients is probably due to the severe disease in patients treated by our Service and that such patients have a higher risk for osteoporosis and its complications. Sixteen patients were hospitalized for a mean period of 12+/-8 days. Nineteen patients were treated with conservative management, four received no specific treatment, and two required surgery. IF were located as follows: tibia (10 cases), fibula (seven), tibia and fibula (eight). The initial radiograph was diagnostic in 20 patients, and in the remaining the diagnosis was made by computed tomography (CT) scan (three cases), magnetic resonance imaging (MRI) (1), and bone scan (1). The diagnostic delay was 76+/-117 days (median, 21). In only five patients the diagnosis of IF was considered at the first examination. All patients had pain on weight bearing and marked functional impairment, 16 had local inflammatory signs, and 10 had deformity. Risk factors for osteoporosis were corticosteroids (13 cases), prolonged immobilization (10), early menopause (2), and methotrexate therapy (10). Eleven patients had osteoporotic fractures in other locations. Eighteen patients had an underlying condition: rheumatoid arthritis (RA, 13 cases), psoriatic arthritis (2), systemic lupus erythematosus (SLE) (1), kidney transplant (1), and Crohn's disease (1). Three cases were diagnosed between 19 (0.42 cases/year) and 22 between 19 (three cases/year). The main predisposing factors, clinical features, therapy, and outcome were retrospectively reviewed.Īll the patients except four were women (mean age, 66+/-12 years). Between January 1984 and July 1997, 25 patients were diagnosed as having IF of the tibia and fibula. IF was considered when occurring spontaneously or with minimal trauma. Our aim was to analyze the main features and outcome of IF of the tibia and fibula in patients attending our Rheumatology Service. IF of the tibia and fibula are probably less common than IF of the ribs, vertebrae, hip, pelvis, and distal ulna, and therefore they are frequently underrecognized and mistaken for other conditions. Insufficiency fractures (IF) occur when normal or physiological muscular activity stresses a bone that is deficient in mineral or elastic resistance.