[Treatment methods and outcomes of tibial shaft fractures in Switzerland. A prospective multicenter study of the Swiss AO].

Fractures of the tibial shaft are very common and often associated with severe tissue damage. The aim of this study was to investigate the methods of treatment, the results and complications of tibial shaft fractures in Switzerland. In a prospective planned study the Swiss Association for the Study of Internal Fixation (AO) analyzed 585 tibial shaft fractures that were treated in 41 hospitals between 1st of July, 1994 and 30th of June, 1995. The cases were documented in the specific AO-documentation-forms, 78.3% (n = 458) of the cases received an effective follow-up. The most common type of accident were sports accidents with 41.5% (n = 243), followed by traffic accidents in 35.6% (n = 208). Conservative treatment was applied in 9.4% (n = 55). The most frequent used implant was the plate in 43.8% (n = 256), followed by the nail in 36.8% (n = 215) and by an external fixator in 9.5% (n = 56). In the group of patients treated with a nail 116 received an AO-Universal nail, 94 were treated with the solid tibial nail (UTN). 92.4% (n = 423) of the fractures healed with radiological alignment. 11.6% (n = 53) had a delayed or non-union. In this group 37.7% (n = 20) of patients sustained severe soft tissue damage, due to high-energy-trauma in 60% (n = 12). Of the patients with delayed or non-union one was treated primarily conservative, eight were treated with a plate, 24 with a nail and 20 with an external fixator primarily. The indications for fracture treatment with a plate or a nail was nearly the same in different fracture types. In summary, in Switzerland most tibial shaft fractures were treated with a plate or a nail with an equally good outcome.