Open fractures of the tibia are the commonest of open long-bone fractures, perhaps because of its thin anteromedial soft-tissue coverage.
They are caused by various mechanisms, ranging from low-energy twisting forces to high-energy motor vehicle crashes or penetrating injuries (gun shots, blasts). Although the principles of management for open tibial fractures are constant, the path to the final result may vary.
Open tibial fractures can present as isolated injuries or in the context of a multiply injured patient. The patient’s clinical status must dictate the primary and ongoing treatment of the open tibial fracture. Thorough evaluation of the entire patient is essential before focusing on the injured leg.