Clinical epidemiological analysis of adult spiral tibial shaft fracture associated with ipsilateral posterior malleolar fracture

Abstract

To investigate the clinical epidemiological features of adult spiral tibial shaft fracture associated with ipsilateral posterior malleolar fracture, a special kind of fracture. The clinical data of 1685 cases of adult tibial and fibular shaft fracture were analyzed retrospectively. The cause and mechanism of spiral tibial shaft fracture associated with ipsilateral posterior malleolar fracture were studied in detail. The male and female ratio in adult tibial and fibular shaft fracture was 4.52:1. Most of adult tibial and fibular shaft fracture occurred in the persons aged 31 - 40 (26.0%) and type A fracture accounted for 57.7% of the cases. The male and female ratio in adult spiral tibial fracture was 2.95:1. Most of the adult spiral tibial fracture occurred in those aged 41 - 50 (32.6%). With a male and female ratio of 6:1 (24:4) and mostly occurring in the persons aged 41 - 50, spiral tibial shaft fracture associated with ipsilateral posterior malleolar fracture composed 9.7% (28/288) of total tibial fractures and 1.7% (28/1685) of total spiral tibial and fibular fractures. Missed diagnosis rate of spiral tibial shaft fracture associated with ipsilateral posterior malleolar fracture was 67.9% (19/28) in the Department of Radiology and 53.6% in the Department of Orthopedics. With a high incidence, spiral tibial shaft fracture associated with ipsilateral posterior malleolar fracture was caused by a low energy but not an iatrogenic damage. With a high rate of missed diagnosis, the spiral tibial shaft fracture associated with ipsilateral posterior malleolar fracture should be paid more attention to clinically.