42t-D/5.1   Simple oblique or spiral tibial fracture

Simple oblique (>30°) or spiral fractures of the tibial shaft are classified 42t-D/5.1. They may occur in the proximal, middle, or distal third of the femoral shaft.

An accompanying fibular shaft fracture is classified separately.

These fractures are often the result of a rotational force.

Differentiation between length-stable and length-unstable fractures is crucial for decision-making and choice of operative technique.

Isolated tibial fractures are axially unstable. They are associated with varus deformity due to muscle pull and buttressing effect of the intact fibula and require close surveillance in the weeks following injury.

An associated fibular fracture decreases the overall stability.

Oblique tibial shaft fracture with associated proximal fibular fracture

Isolated tibial shaft fracture with varus deformity