title: [Open fractures of the tibia in the adult: surgical treatment and complications].
abstract: Open tibial shaft fractures represent high-energy trauma and are associated with a substantial risk of complications. Management is an emergency, and the first steps in treatment include antibiotic prophylaxis, tetanus booster, surgical debridement, irrigation of the wound and stabilization of the fracture. The Gustilo and Anderson classification helps to guide definitive treatment. Intramedullary nailing is the surgical technique of choice. An indirect approach utilizing external fixation is recommended for Gustilo IIIB and IIIC fractures. The most prevalent complications are compartment syndrome (10%), infection (2%-40% without antibiotics according to Gustilo grading, most notably in the presence of vascular lesions), aseptic nonunion (23%), venous thromboembolism (60% without prevention) and anterior knee pain (>50%).
authors.affiliation: Service de chirurgie orthopédique et de traumatologie de l'appareil moteur, HUG, Genève. raphael.kohlprath@gmail.com
authors.forename: R
authors.initials: R
authors.lastname: Kohlprath
authors.forename: M
authors.initials: M
authors.lastname: Assal
authors.forename: I
authors.initials: I
authors.lastname: Uçkay
authors.forename: N
authors.initials: N
authors.lastname: Holzer
authors.forename: P
authors.initials: P
authors.lastname: Hoffmeyer
authors.forename: D
authors.initials: D
authors.lastname: Suva
mesh_terms: D000328:Adult; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D011182:Postoperative Care; D011183:Postoperative Complications / Q000628:therapy; D011300:Preoperative Care; D013978:Tibial Fractures / Q000601:surgery*