Tibial shaft fractures: A biomechanical and clinical approach: Thesis summary

Abstract

Among the problems associated with the use of tibial functional bracing for the management of tibial shaft fractures, are post-fracture ankle stiffness and the duration of immobilization. This study was undertaken to investigate in detail these two problems. It involved the design and assessment of a new type of brace called the `2 in 1 functional brace'. This brace encompasses the design features of `Gaiters' and `Sarmiento casts', retaining their advantages, while still being less expensive and less time-consuming to apply. A `gaiter' with a sarmiento shaped top is fashioned followed by the application of a `foot-piece'. Application of this composite brace achieves the advantages of a `sarmiento cast'. The foot-piece could be bivalved and removed, leaving the undamaged underlying modified gaiter in place and allowing full ankle motion. The study was conducted in three parts: Part 1 deals with the problem of clarifying the biomechanical function of the brace; Part 2 of the study concentrated on the problem of determining the optimum duration of immobilization in the brace; and Part 3 of the study tested the new design of brace in a clinical trial on 80 patients.