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Orthofix Research Form #1 – Tibial Shaft Fractures – New Patient

- Inclusion Criteria:
 
 
 
 
- age: 10 to 70 years
 
 
 
 
- no inflammatory arthritis;
 
 
 
 
- no proximal or distal articular involvement

Date:  
 
 
 

Physician:  

Patient name:  
Age:  

Type of Injury:

Number of Hours Standing at Work Before Surgery

PreOperative Smoking History:

Past Medical History:

Past Medical History:

Time in Hosptial:


Original Text by Clifford R. Wheeless, III, MD.


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