title: Poor retention after closed reduction and cast immobilization of low-energy tibial shaft spiral fractures.
abstract: OBJECTIVE
  The aim of this retrospective study was to analyze retention in cast after closed reduction of low-energy two-fragment tibial shaft fractures.
  
  
  METHODS
  The material consisted of 72 closed tibial shaft fractures AO/ ASIF type A treated with closed reduction and plaster cast. Fractures were subgrouped according to the AO/ASIF classification and the initial fracture displacement was measured. Final alignment and the frequency of operative intervention due to early loss of reduction were analyzed.
  
  
  RESULTS
  40% of all fractures lost reduction and were operated on. The largest subgroup was A1.2 fractures, a spiral tibial shaft fracture with a fibular fracture at another level. Out of the 28 fractures in this group 61% were converted from cast to early operative intervention.
  
  
  CONCLUSIONS
  Closed reduction and cast treatment of spiral tibial shaft fractures AO/ ASIF type A1.2 had a high failure rate.
authors.affiliation: Department of Orthopedics, Uppsala University Hospital, Sweden. tomas.borg@jll.se
authors.forename: T
authors.initials: T
authors.lastname: Borg
authors.forename: T
authors.initials: T
authors.lastname: Melander
authors.forename: S
authors.initials: S
authors.lastname: Larsson
mesh_terms: D000293:Adolescent; D000328:Adult; D002370:Casts, Surgical; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013978:Tibial Fractures / Q000601:surgery*; D016896:Treatment Outcome