Mid to distal third tibial shaft fractures caused by gunshots: Characterization and incidence of distal intra-articular extension

The incidence of intra-articular involvement for tibial shaft fractures secondary to gunshot is less than that reported for spiral type fractures (11-45% vs. 25-58%). Although radiographs have a high specificity, the sensitivity is lower than expected, with worse outcomes if a fracture is missed. We recommend that a CT scan should be utilized to determine intra-articular extension in the setting of tibial shaft fractures caused by gunshots.