Conservative Treatment of Closed and Gustilo Type-I Tibial Shaft Fracture

Abstract

Background: As the tibia is a subcutaneous bone tibial shaft fractures are the common long-bone fractures, mostly closed and Gustilo Type-I. Various treatment methods including conservative treatment external fixation, intramedullary nailing and plate fixation have been suggested but none of these is considered the “gold slandered” for these injuries. Objective: The objective of this study is to evaluate the outcome of conservative treatment of closed and Gustilo Type-I tibial shaft fractures. Methods: A total of 43 fractures of the shaft of the tibia were treated with closed reduction and a long leg cast for eight to ten weeks followed by a PTB cast for another six to eight weeks from July 2018 to June 2021. One year follow up was done with 33 patients, ten months follow up with seven patients and three patients were lost to follow up. Results: All fractures united within six months of duration. Immediate post-reduction angulation was 2.52 degrees in the sagittal plane and 3.12 degrees in the coronal plane. The average final angulation was 4.45 degrees in the sagittal plane and 3.85 degrees in the coronal plane. The average limb length shortening was 5.4 mm. A full range of motion was gained compared to the normal side by six months of follow up. Conclusion: Closed Tibial shaft fractures can be treated conservatively with closed reduction and cast immobilization with many advantages over operative methods.