1. Yelin EH, Felts WR. A summary of the impact of musculoskeletal conditions in the United States. Arthritis Rheum 1990;33:750‑5.
2. Martinez A, Sarmiento A, Latta LL. Closed fractures of the proximal tibia treated with a functional brace. Clin Orthop Relat Res 2003 ;417:293‑302.
3. Sarmiento A, Burkhalter WE, Latta LL. Functional bracing in the treatment of delayed union and nonunion of the tibia. Int Orthop 2003;27:26‑9.
4. Sarmiento A, Gersten LM, Sobol PA, Shankwiler JA, Vangsness CT. Tibial shaft fractures treated with functional braces. Experience with 780 fractures. J Bone Joint Surg Br 1989;71:602‑9.
5. Sarmiento A, McKellop HA, Llinas A, Park SH, Lu B, Stetson W, et al. Effect of loading and fracture motions on diaphyseal tibial fractures. J Orthop Res 1996;14:80‑4.
6. Sarmiento A, Latta L. The evolution of functional bracing of fractures. J Bone Joint Surg Br 2006;88:141‑8.
7. Kuzgun U, Ozturk I, KabukcuogIu Y, Ordveri M. The results of conservative and surgical treatment of tibial plateau fractures. Acta Orthop Traumatol Turc 1991;25:391‑3.
8. Sarmiento A, Sharpe FE, Ebramzadeh E, Normand P, Shankwiler J. Factors influencing the outcome of closed tibial fractures treated with functional bracing. Clin Orthop Relat Res 1995 ;315:8‑24.
9. Pandey BK, Manandhar RR, Sharma S, Pradhan RL, Lakhey S, Rijal KP. Conservative treatment of nonarticular fractures of distal third tibia. JNMA J Nepal Med Assoc 2009;48:292‑5.
10. Sarmiento A, Latta LL. Fractures of the middle third of the tibia treated with a functional brace. Clin Orthop Relat Res 2008;466:3108‑15.
11. Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non‑randomised studies of health care interventions. J Epidemiol Table 3: The main clinical findings of the studies on tibia fracturesResearcher Method Results and findingSarmiento et al.[8]943 patients with tibia fracture (211 female and 732 male). Mean of their age was 33±13 years. Prefabricated functional brace was applied between
1.4 and 23 weeks (mean 3.7 weeks) after injury41% of fractures healed with no angulations in sagittal plane. 95% of them
healed with angulations <6°. Posterior angulations were seen in 30% of the subjectsJafari and Nozarnejad[14]26 subjectswith mean age of 27.46±7.58 yearsFollow-up was 9.12±2.36 monthsThe classification of fractures was done using AO/OTA classification (38.5% A1, 26.9% A2, 34.6% A3.1)Most of fractures were sustained in lower third of tibia (53.85%)
All fractures eventually healed in an average of 13.7 weeks. In 12.3% of patients, shortening of bone was <1 cm. Anterior or posterior angulations were more than 10° in 2 patientsIn 4 patients varus angulations was more than 5°. Finaldeformity was observed in 8 patients (30.77%). The non-surgical treatments outcomes were not satisfactory, despite considering all principles for conservative treatmentSarmiento et al.[4]780 tibia fractures treated with prefabricated functional braces were followed. The average time before applying a brace was 3.8 weeks for closed fractures and 5.2 weeks for opened fractureClose fractures healed in an average of 17.4 weeks and opened fractures in an average of 21.7 weeks. 90% with shortening <10 mm. No association between fracture healing and age, mechanism of injury and fracture location. Degree of soft tissue damage influences the success of and speed of fracture healing. The condition of fibula and the time frominjury to bracing also appeared to affect the speed of unionMartinez et al.[2]108 closed fractures located in the proximal third of tibia were treated with functional brace88% of the subjects were treated with <6° of angular deformity and final shortening was 3.5 mm. Use of functional brace is a valuable method for tibia fracture healing at the proximal partSarmiento[13] 1000 closed tibia fractures treated with prefabricated functional below knee braceThe mean final shortening before treatment was 4.28 mm compared to initial shortening of 4.25 mm. The final shortening did not increase beyond the acceptable rangeKuzgun et al.[7]35 subjects with tibia plate fracture were recruited in this study.They were treated by surgery or by use conservative treatmentThe type of fracture was determined based on Hohl classification. Pain, walking capacity, total range of motion of knee joint and stability were the evaluated
criteriaThere was compression of 0-5 mm in 21 cases, 5-10 mm in 12 cases, and 10 mm in 2 cases. Both methods have satisfactory results. The period of immobilization was averaged 6.6 weeks in conservative treatment and 5 weeks in surgical. The weight bearing was allowed after 2-4 weeksAO: Arbeitsgemeinschaft für Osteosynthesefragen
12. Swenson E, DeHaven K, Sebastianeli W. Pneumatic leg brace after tibial stress fracture for faster return to play. Am J Sports Med 1997;25:322‑8.
13. Sarmiento A. On the behavior of closed tibial fractures: Clinical/radiological correlations. J Orthop Trauma 2000;14:199‑205.
14. Jafari D, Nozarnejad P. Outcomes of the isolated closed tibial shaft fractures treated nonsurgically. Med J Islamic Rep Iran 2011;25:21‑6.
15. Al‑ShadediA, Adnan H, Luay M. Functional bracing in the management of diaphyseal fractures of Tibia. Iraqi Postgrad Med J 2008;7:295-303.
16. Madadi F, Vahid Farahmandi M, Eajazi A, Daftari Besheli L, Madadi F, Nasri Lari M. Epidemiology of adult tibial shaft fractures: A 7‑year study in a major referral orthopedic center in Iran. Med Sci Monit 2010;16:CR217‑21.
17. Bengnér U, Ekbom T, Johnell O, Nilsson BE. Incidence of femoral and tibial shaft fractures. Epidemiology 1950‑1983 in Malmö, Sweden. Acta Orthop Scand 1990;61:251‑4.
18. Sarmiento A, Latta LL. Functional fracture bracing. J Am Acad Orthop Surg 1999;7:66‑75.
19. Sarmiento A, Sobol PA, Sew Hoy AL, Ross SD, Racette WL, Tarr RR. Prefabricated functional braces for the treatment of fractures of the tibial diaphysis. J Bone Joint Surg Am 1984;66:1328‑39
)