Predictors of reoperation following operative management of fractures of the tibial shaft

Three risk factors were found to be associated with reoperation within one year following surgery for tibial shaft fractures. Of 192 patients who underwent surgical treatment for tibial shaft fractures, 43 (22.4%) required reoperation at a mean of 18 weeks (range 6 - 52 weeks). The presence of an open fracture wound, lack of cortical continuity between the fracture ends following fixation, and the presence of a transverse fracture all predicted reoperation. No interaction between the treatment method (plate or nail) and any of the predictive variables was seen. Patients with none of the three risk factors had a risk of reoperation of 3.8%. Patients with one risk factor had a reoperation rate of 17.7%. Patients with two risk factors had a reoperation rate of 47%, and of the 16 patients with all three risk factors 14 (94%) required reoperation.