Bilateral tibial shaft fractures represent high-energy trauma. While treatment and complications of bilateral femoral fractures are well defined, there is limited literature on bilateral tibial shaft fractures. We present a multicenter study on bilateral tibial shaft fractures, analyzing the most commonly associated injuries and complications.
A retrospective review was performed to identify all patients with bilateral tibial shaft fractures treated during a 5-year period. Demographics, injury measures, treatments, and complications were collected. Categories were evaluated and ranked based on frequency of occurrence.
Approximately 2000 tibial shaft fractures were treated during a 5-year period, of which 68 patients (19 females, 49 males) had sufficient records for inclusion. The average age was 39 yr (range 15-83 yr). There were 80 open fractures in 55 patients. Other musculoskeletal trauma and chest trauma were the two most common associated injuries (followed by face, head, and abdominal trauma). Two patients had definitive casting, 67 patients (129 tibias) were surgically treated, and four patients required amputation on arrival. Fourteen patients developed nonunions, 13 had compartment syndrome, and 34 were affected by nonsurgical complications. Thirty-one patients required subsequent surgery to promote healing. There were six mortalities.
We present the largest group of patients with bilateral tibial fractures and show a high rate of open fractures, severe systemic injuries, and frequent complications. Orthopaedic surgeons must balance early surgical treatment with the presence of associated injuries and educate patients regarding complications and the possibility of subsequent surgeries to promote healing of these serious injuries.