Description
In this presentation, John Keating discusses the advancements and historical context surrounding the treatment of tibial fractures, particularly in the 21st century. He begins by outlining the evolution of fracture management from the 1960s, where non-operative casting was the norm, to the introduction of plate fixation in the 1970s and the subsequent shift toward external fixation in the 1980s. Highlighting the complications associated with these methods, he emphasizes the emergence of intramedullary nailing in the 1990s as a more effective treatment option, leading to better healing outcomes and lower rates of malunion and infection. Keating notes the consistent reliance on intramedullary nailing for both closed and open tibial fractures, while acknowledging the similar efficacy of this method in comparison to external fixation. He raises concerns about the limited progress in treatment approaches over the last two decades despite advancements in technology and classification systems. Furthermore, he calls for more standardized definitions in clinical outcomes and larger trauma databases to better understand the efficacy of novel treatment strategies. The presentation concludes with a recognition of the importance of continuous research to improve the management of complex tibial shaft fractures.
DOI: 10.1302/3114-221314