Pearls and pitfalls with proximal third tibial fractures

By Douglas W. Lundy, MD, FACS, and Robert P. Dunbar Jr., MD

Seven suggestions for avoiding potential complications

Last month (AAOS Now, September 2007), we discussed pearls and pitfalls in the treatment of tibial plateau fractures. This month, the focus is on proximal third tibial fractures, such as the one depicted in Figure 1. This fracture of the proximal tibial metadiaphysis had been nailed 6 months previously. The patient had obvious angulation of the leg, a limb-length discrepancy, and significant pain with ambulation.

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