Open tibial fractures are relatively difficult to manage. Segmental tibial fractures are more difficult to manage. Open, segmental tibial fractures are even more difficult to manage.
If the segmental fragment is avascular, question arrises whether is not better to remove it and proceed with bone transport or bone graft. I assume it depends amongst other factors, on the length of the segment.
Mr Matija Krkovic, MD, PhD
I am Consultant Orthopaedic Trauma Surgeon with special interest in Limb reconstructions and bone infections.