Conservative treatment of tibial fractures. Results in a series of 163 patients.

The purpose of this study was to assess the results of conservative treatment of tibial fractures. The series consisted of 165 tibial fractures in 163 consecutive patients. Over one-fifth (35) were open fractures. The treatment was in the main conservative, the primary treatment of only three fractures was operative. Full weight-bearing was started after 124 days on average. The average duration of primary treatment by plaster immobilization was 99 days. A questionnaire was completed and returned by 84% of the patients. Symptomatic, clinically and radiologically evident deep venous thrombosis was observed in 0.6%, pulmonary embolism in 1.9%, signs of fat embolism in 1.9%, superficial infection in 3.1%, osteitis in 0.6% and refracture in 2.5% of fractures. The average time to union was about 14 weeks. The incidence of radiological malpositions developing during the time of treatment was high. The risk of shortening was associated with oblique and severely comminuted fractures and possibly also with severely displaced fractures. Subjective sequelae were reported by a large number of patients. An optimal result is not guaranteed in all tibial fractures by conservative treatment.