Tibial Fractures

DENVER — Posterolateral plating is a viable alternative treatment for distal tibia fractures, according to results presented at the Orthopaedic Trauma Association Annual Meeting.

DENVER — Delayed irrigation and debridement did not independently increase the risk of unplanned reoperation for infection or wound-related complications in patients with open extremity fractures, according to results presented here.

DENVER — Patients with proximal tibia fractures treated with nails compared with locked plates were not different with regard to radiographic, functional and patient-based outcomes, according to a presenter at the Orthopaedic Trauma Association Annual Meeting.

The answer to the question is “yes and no.” Orthobiologics are adjuvants that are thought to improve the endogenous healing potential of the injured skeletal element. Although orthopedic implants and surgical techniques have improved significantly over the last few decades, we still encounter fractures that, despite all efforts, fail to unite. These are the situations where orthobiologics will make a difference. Unfortunately, at this stage, we are unable to predict at the time of the index surgery who will unite and who will end up with a nonunion. In addition, we can often only guess whether a growth factor is needed, a fracture site is lacking skeletal stem cells or the stem cells are less osteogenic due to an underlying medical condition. Once we are able to identify the fracture that will require augmentation with a biologic, such as bone marrow aspirate concentrate, platelet-rich plasma or others, then we will be able to recommend meaningful use of orthobiologics for primary trauma cases. Until then, the use will be limited to patients in which the past medical history or clinical appearance of the injured limb suggest suboptimal healing potential. While this is not a wrong approach per se, it will lead to overuse of these costly products.


Some factors related to the patient or surgery, including inadequate blood flow and fracture stability, can result in fracture nonunion. However, literature shows most of these traumatic fractures promptly heal after surgical treatment. For those that do not, sources told Orthopedics Today the use of orthobiologics may provide a needed boost in healing.