PRESENTATION AND MANAGEMENT OF BILATERAL TIBIAL SHAFT FRACTURE: A PROSPECTIVE CASE SERIES OF RARE ENTITY AND REVIEW OF LITERATURE

Introduction: Unlike unilateral tibia fracture bilateral tibia fractures are rare and often associated with multiple systemic injuries results from high energy trauma in motor vehicle accidents, sports or falls from height. Management and complications of such injuries are little existing in the literature. Materials and methods: Demographics, the severity of the injury, fractur e pattern, the extent of the open fracture, associated injuries and treatmen ts were documented in a prospective, single center study of nine cases. Complications and outco me were recorded in follow-up. Results: Eight were an adult male and one was a female chi d. Mean age was 24.55 year (range, 3 to 33). 11.11% had bilateral closed, 22.22% susta ined bilateral open, and 66.66% had unilateral open fracture. The most common associated injury wa s fracture distal radius in 44.44% followed by shoulder dislocation (22.22%) and fracture proxi mal humerus (11.11%). The New Injury Severity Score was range from 18 to 27. 27.77% (5, tibia) cases (Total 18 tibia) managed with definitive casting and remaining 72.22% cases were treated with immediate (11, tibia) and delayed intramedullary nailing (2, tibia). Complica t ons were included superficial wound infection, wound necrosis and delayed union, requir ed additional surgeries. Average hospital stay was 19.88 days (range, 7-45 days). 66.66% of cases went on heal without complication. The average follow-up was 8 months (range, 3-12 months) . Conclusion: Bilateral tibial shaft fractures can associate with musculoskeletal injuries in other region and show a high rate of open fractures which may require additional procedures.