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Skiers' lower leg shaft fracture

Outcome in 91 cases treated conservatively with Sarmiento's brace

Clinic of Orthopaedic Surgery, University Hospital, Geneva, Switzerland

Pierre Bachelin, MD

Clinic of Orthopaedic Surgery, University Hospital, Geneva, Switzerland

Daniel Fritschy, MD

Clinic of Orthopaedic Surgery, University Hospital, Geneva, Switzerland

We report our experience using Sarmiento's method for the conservative treatment of 91 consecutive frac tures of the lower leg. The mean age of the patients in our series was 34 years. One patient had an open fracture. All of the patients were followed and were evaluated clinically and radiographically 6 to 12 months after injury.

After a period of immobilization by traditional methods (traction/long leg cast), the Sarmiento brace was ap plied at a mean of 42 days, allowing early weightbearing and mobilization. The brace was removed at a mean of 90 days. Clinical results were excellent; there was minimal persistence of knee or ankle limitation; 84% of the patients had less than 5 mm of final shortening; 96% had less than 4° of final angulation. Work was resumed at a mean of 103 days. We had one nonunion, which we treated operatively 6 months after injury by osteosynthesis and autologous bone grafting. All of the patients were asked to complete a questionnaire; 51 % responded, with an average followup of 5 years (range, 1 to 10 years). These patients had been able to resume sports activity 8 months after injury; 52% were skiing 1 year after injury, and 96% were satisfied with the treatment method used. One patient complained of persistent pain.

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