title: Fracture healing in tibia fractures with an associated vascular injury.
abstract: BACKGROUND
  Tibial fractures with an associated vascular injury are a challenging management problem for the orthopedic and vascular surgeon. The effect of a concomitant vascular injury on fracture healing has not been specifically delineated previously.
  
  
  METHODS
  We performed a retrospective review of 29 fractures of the tibial shaft with an associated vascular injury in 28 patients.
  
  
  RESULTS
  Overall there were 44 vessels injured (38 arterial and six venous). A total of six patients had an amputation performed; patients requiring amputation were significantly older than those without amputation. Fractures with an associated injury to the posterior tibial artery had a significantly higher nonunion rate and a greater number of weeks to union than fractures without this vascular injury.
  
  
  CONCLUSIONS
  Outcomes of tibial fractures with an associated vascular injury are poorest in older patients (who are at increased risk of amputation) and those with an injury to the posterior tibial artery (who are at increased risk of delayed union and nonunion).
authors.affiliation: Fondren Orthopedic Group L.L.P., Texas Orthopedic Hospital, Houston 77030, USA.
authors.forename: M R
authors.initials: MR
authors.lastname: Brinker
authors.forename: D E
authors.initials: DE
authors.lastname: Bailey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D002648:Child; D002675:Child, Preschool; D005260:Female; D017102:Fracture Healing; D018460:Fractures, Comminuted / Q000601:surgery; D005599:Fractures, Ununited / Q000601:surgery; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000209:etiology / Q000601:surgery; D009131:Muscle, Smooth, Vascular / Q000293:injuries*; D012189:Retrospective Studies; D016909:Tibial Arteries / Q000293:injuries; D013978:Tibial Fractures / Q000150:complications* / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome