tibial fracture

^[1]^[2]^[3]

Classification

orthopedic surgery
immobilization
two bone morphogenetic proteins are used in special circumstances
- Infuse (BMP2)
  - used for treating open tibial shaft fractures
- Osigraft (BMP7)
  - indicated in treatment of traumatic tibial fracture with non-union of at least 9 months duration in skeletally mature patients, in cases where autograft has failed or is unfeasible
DVT prophylaxis unnecessary^[1]
low-intensity pulsed ultrasound (FDA-approved) to accelerate fracture healing & avert nonunion but of no benefit^[2]

↑ ^1.0 ^1.1 ^1.2 Selby R et al. Symptomatic venous thromboembolism uncommon without thromboprophylaxis after isolated lower-limb fracture: The Knee-to-Ankle Fracture (KAF) cohort study. J Bone Joint Surg Am 2014 May 21; <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24875035 <Internet> http://jbjs.org/content/96/10/e83
Selby R et al. PAPER 031: CLINICALLY-IMPORTANT VENOUS THROMBOEMOLISM (CIVTE) FOLLOWING ISOLATED LEG FRACTURES DISTAL TO THE KNEE: EPIDEMIOLOGY & PREVENTION: THE D-KAF (DALTEPARIN IN KNEE- TO-ANKLE FRACTURE) TRIAL. J Bone Joint Surg Br 2010 vol. 92-B. no. SUPP I 7 http://www.bjjprocs.boneandjoint.org.uk/content/92-B/SUPP_I/7.3.abstract
↑ ^2.0 ^2.1 Busse JW, Bhandari M, Einhorn TA et al. Re-evaluation of low intensity pulsed ultrasound in treatment of tibial fractures (TRUST): Randomized clinical trial. BMJ 2016 Oct 25; 355:i5351. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27797787 Free Article <Internet> http://www.bmj.com/content/355/bmj.i5351
Griffin XL. Low intensity pulsed ultrasound for fractures of the tibial shaft: We now have sound evidence that it doesn't work. BMJ 2016 Oct 25; 355:i5652 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27780808 Free PMC Article <Internet> http://www.bmj.com/content/355/bmj.i5652
↑ Cluett J Tibia Fracture http://orthopedics.about.com/od/brokenbones/a/tibia.htm