Diaphyseal Tibial Fractures Clinical Presentation

Updated: Sep 04, 2018
  • Author: Murali Poduval, MBBS, MS, DNB; Chief Editor: Thomas M DeBerardino, MD  more...
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Presentation

History and Physical Examination

Upon admission, a detailed patient history must be obtained to determine the nature of the injury and to determine whether any other injuries are present.

Clinical examination starts with excluding life-threatening injuries and stabilizing all vital parameters. A comprehensive screening to rule out pelvic, abdominal, chest, and head injuries is necessary. Thereafter, attention should be given to the limb to immediately assess for limb-threatening vascular and neurologic injuries.

The patient should be assessed for compartment syndromes, closed soft-tissue injury, and open wounds (see the image below). The extent of injury is roughly classified, with the final assessment coming when the patient enters the operating suite. A bulky dressing and an above-the-knee splint are applied, and radiographs are ordered.

Compound grade 3C injury with an extensive soft-ti Compound grade 3C injury with an extensive soft-tissue injury.