The point of view of the clinician: A prospective study of the mechanism of accidents and the morphology of tibial and fibular shaft fractures

In a prospective study of 210 tibial shaft fractures, the accident mechanis ms and the resultant fracture morphologies were analyzed. 86 fractures occurred due to indirect impact. The fracture morphology in th is group consisted of short and long spiral fractures resulting from rotati onal injuries complicated by anterior torsion butterfly fragments if the pe rson fell forward, posterior torsion butterfly fragments if they fell backw ards and complicated by multiple torsion butterfly fragments if it was a hi gh velocity injury. 124 fractures occurred due to direct impact. The fracture morphology in thi s group consisted of transverse, oblique segmental or crush fractures, comp licated by one or more butterfly fragments due to bending, the injury depen ding on whether it was pure, one-point, three-point, or four-point-bending and on additional axial loading and velocity. In the indirect impact group, there were a few soft tissue injuries and fib ular fractures at a different level to the tibial fracture. In the direct g roup, a large number of soft tissue injuries and fibular fractures at the l evel of impact were found.