High-energy proximal tibial fractures: treatment options and decision making.

Nirmal C. Tejwani, David J. Hak, Christopher Glenn Finkemeier, Philip R Wolinsky

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


High-energy proximal tibial fractures are complex injuries with significant associated soft-tissue damage. There is a high percentage of open injuries, compartment syndrome, and vascular injuries in patients with these fractures. These patients usually have significant articular depression, excessive comminution, condylar displacement, and metadiaphyseal extension of the fracture. Management of these complex injuries requires treatment of the soft tissues and bony components. Surgical treatment of these injuries traditionally has been associated with substantial complications such as infection, knee stiffness, malunion, loss of fixation, soft-tissue failure, and amputations. Staged treatment, with initial application of a spanning external fixator followed by definitive fixation, has been used in recent years to decrease the risk and rate of complications. Definitive fixation may be performed using traditional open approaches or percutaneously or an external fixator may be used. Development of a protocol for treating these injuries must be done to allow optimal fracture and patient outcomes.

Original languageEnglish (US)
Pages (from-to)367-379
Number of pages13
JournalInstructional course lectures
StatePublished - 2006
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)


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