Evidence-based guideline for diagnosis and early fixation of severe open tibiofibular fractures (version 2025)
- VernacularTitle:严重开放性胫腓骨骨折诊断及早期固定循证指南（2025版）
- Author:
Yongjun RUI
1
;
Yongqing XU
;
Qingtang ZHU
;
Xin WANG
;
Zhao XIE
;
Shanlin CHEN
;
Jingyi MI
;
Xianyou ZHENG
;
Juyu TANG
;
Xiaoheng DING
;
Aixi YU
;
Tao SONG
;
Jianxi HOU
;
Jian QI
;
Xinyu FAN
;
Jun FEI
;
Lin GUO
;
Xingwen HAN
;
Weixu LI
;
Aiguo WANG
;
Yun XIE
;
Tao XING
;
Meng LI
;
Baoqing YU
;
Yan ZHUANG
;
Xiaoqing HE
;
Tao SUN
;
Pengcheng LI
;
Jihui JU
;
Hongxiang ZHOU
;
Haidong REN
;
Guangyue ZHAO
;
Gang ZHAO
;
Yongwei WU
;
Jun LIU
;
Yunhong MA
;
Yapeng WANG
Author Information
- Publication Type:Journal Article
- Keywords: Tibial fractures; Fibula; Infection; Fracture fixation; Surgical flaps
- From: Chinese Journal of Trauma 2025;41(11):1021-1034
- CountryChina
- Language:Chinese
- Abstract: Severe open tibiofibular fractures account for approximately 28.1% of all open fractures. Among them, Gustilo-Anderson type IIIB/C fractures present significant clinical challenges due to associated bone and soft tissue defects, high infection rates, and risk of amputation. Inadequate preoperative assessment may lead to suboptimal emergency surgical planning or intraoperative complications. Historically, external fixation was often preferred, but this approach has been associated with limitations such as restricted joint mobility, delayed bone union, joint stiffness, and disuse osteoporosis, resulting in poor functional recovery. With advancements of debridement techniques, standardization of antibiotic use, and popularization of early soft tissue coverage, early internal fixation has gained broader acceptance. Nevertheless, controversies persist regarding the choice of fixation method, timing of definitive fixation, use of reamed versus unreamed intramedullary nailing, and necessity of fibular fixation. To standardize the diagnosis and early management of severe open tibiofibular fractures, reduce complication rates, and improve functional recovery, the Society of Microsurgery of the Chinese Medical Association organized a panel of domestic experts to develop the Evidence-based guideline for the diagnosis and early fixation of severe open tibiofibular fractures ( version 2025), using evidence-based methodology. The guidelines provided 12 recommendations covering diagnostic and early fixation strategies of severe open tibiofibular fractures, aiming to provide clinicians with scientifically grounded and standardized guidance.
