While most tibial fractures will heal without complication, there are risks of both surgical and nonsurgical treatment of these injuries. A conversation with your healthcare provider is best to determine what the best course of action is in this situation. One of the most common causes of a nonunion is tobacco use, where the use of nicotine leads to delayed healing of the fractured bone, so it's important to avoid smoking and other forms of tobacco intake. Nonunions are not common with everybody-they are more common after more severe injuries and open fractures, or in people with medical conditions that may impair bone healing.
One particular concern with tibia fractures is called a nonunion, a condition where the bone fails to heal. When there is a significant soft-tissue injury, the external fixator may provide excellent immobilization while allowing monitoring and treatment of the surrounding soft-tissues. In these cases, the placement of IM rods or plates may not be possible because of soft-tissue injury. External fixators tend to be used in more severe fractures, especially open fractures with associated lacerations and soft-tissue damage. External Fixator: An external fixator may also be helpful in some particular fracture types.In these fractures close to the joint surface, a plate and screws may be the ideal method of fixation. Many surgeons choose an IM rod for tibial shaft fractures unless the fracture is too close to the joint to allow for accurate fixation due to the fracture pattern. Plates and Screws: Plates and screws can also be used in some fracture types, especially those closer to the knee or ankle joints (such as tibial plateau and tibial plafond fractures).Infection of the rod may require removal of the rod in order to cure the infection. The most common risk of surgery is knee pain, and one of the most concerning complications after surgery can be an infection. Tibial rodding provides excellent fixation and alignment of the bones. The metal screws and the rod can be removed if they cause problems, but can also be left in place for life. In addition, some fractures may require an incision near the fracture to realign the bones. IM rods are secured within the bone by screws both above and below the fracture. Patients will have an incision over the knee joint, and small incisions below the knee and above the ankle. A tibial rodding is a surgical procedure that lasts about an hour and a half and is usually done under general anesthesia. Intramedullary (IM) Rodding: Intramedullary rodding is a procedure to place a metal rod down the center of the tibia to hold the alignment of the bone.
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