Bridge-Plating Technique for Tibial Shaft Fractures: Is Rotation Deformity a Rare Complication

Objective: Assess postoperative rotational deviation in patients treated with bridge-plating technique for tibial shaft fractures. Methods: Between 2002 and 2005, 113 patients with tibial shaft fractures were surgically treated in a general trauma center. Seventy-one underwent the bridge-plating technique. CT scan measured tibial rotation. All fractures were classified using AO Classification System and divided into sub-groups according to anatomic location (proximal, medial, distal, and segmented), exposure (closed and open, sub-classified using Gustilo Method), and internal or external rotation percentage. Results: No significant difference in tibial rotation was found in fracture location and type (A or B). External rotation was two times more frequent than internal rotation. Rotational deviation following the bridge-plating technique occurred mainly in Type C and open (high energy) fractures. Conclusion: Regardless of tibia fracture location, rotational deviations are related to trauma energy, and thus more difficult to control using the bridge-plating technique.