title: Fracture stiffness as a guide to the management of tibial fractures.
abstract: We have studied the progression of healing in 103 unstable fractures of the tibia. In 76 patients we removed the external fixator once the stiffness had reached 15 Nm/degrees in the sagittal plane. Deformity at the site of the fracture subsequently occurred in four patients. In a further 27, we measured stiffness in several planes and removed the fixator only when the stiffness reached 15 Nm/degrees in each. We found that stiffness in two orthogonal planes may differ widely (maximum difference 9.0 Nm/degrees, mean 4.1 Nm/degrees). There were no failures in the second group. We advocate that fracture stiffness be measured in two orthogonal planes when assessing tibial healing and suggest that values above 15 Nm/degrees in two planes give an indication that it is safe to remove the fixator.
authors.affiliation: North Staffordshire NHS Trust, Stoke-on-Trent, England.
authors.forename: R H
authors.initials: RH
authors.lastname: Wade
authors.forename: C I
authors.initials: CI
authors.lastname: Moorcroft
authors.forename: P B
authors.initials: PB
authors.lastname: Thomas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005592:Fracture Fixation; D017102:Fracture Healing / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013978:Tibial Fractures / Q000175:diagnosis / Q000503:physiopathology*