Lower Leg Fracture Irreducibility Resulting From Entrapment of the Fibula Within the Tibial Shaft

The tibia is the most commonly fractured long bone. Tibia fractures are simple, and most are amenable to immediate closed reduction. Reported cases of irreducibility resulting from entrapment of soft-tissue structures are rare. We report the case of a 23-year-old man who, in a high-speed motor vehic...

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Bibliographic Details
Published inThe American journal of orthopedics (Belle Mead, N.J.) Vol. 46; no. 3; p. E160
Main Authors Hughes, Travis M, Rowan, Flynn A, Truchan, Lisa M
Format Journal Article
LanguageEnglish
Published United States 01.05.2017
Subjects
Accidents, Traffic
Fibula - diagnostic imaging
Fibula - injuries
Fibula - surgery
Fracture Fixation, Intramedullary - methods
Fractures, Bone - diagnostic imaging
Fractures, Bone - surgery
Humans
Male
Radiography
Treatment Outcome
Young Adult
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Summary:The tibia is the most commonly fractured long bone. Tibia fractures are simple, and most are amenable to immediate closed reduction. Reported cases of irreducibility resulting from entrapment of soft-tissue structures are rare. We report the case of a 23-year-old man who, in a high-speed motor vehicle crash, sustained a closed lower leg fracture that was later found to have a unique pattern in which the fibula was entrapped in the medullary cavity of the tibia. Limited open reduction was performed, and the entrapped distal fibula was removed with use of a bone hook. The tibia was reduced, and a nail placed in standard fashion. The postoperative course leading to full recovery was unremarkable. This irreducible fracture pattern, not previously reported, should be considered during difficult closed reductions in order to prevent unnecessary neurovascular or bony injury.
ISSN:1934-3418