Treatment of Unstable Tibial Fracture Using Interlocking Intramedullary Nailing

Oh, In Suk; Moon, Do Hyun; Ko, Jin Hong; Lee, Su Chan; Jang, Yeoung Hun

Abstract

With increasing industrial and traffic accident, tibia fractures by high energy has been increased and their treatment is difficult. There are many controversy concerning the method of treatment, because of many complications, such as malunion, delayed union, nonunion, infection and joint contracture. The use of an intramedullary nail with interlocking bolts, either closed or open thchnique has became an attractive alternative method of treatment for unstable fracture of tibia. From Januaiy, 1987 to December,1992 we treated 63 fractures of the tibia by minipulative reduction and fixation of the fracture fragments with rigid intramedullary nail at Department of Ouhopaedic Surgery Choong-ang Gil Hospital. The following result was obtained. 1) The average time from injury to operation is in closed and open fracture, 6 and 21 days respectively. 2) Of 63 fractures, 60 fractures united and the union rate was 95.2% 3) The average time of bone union was the 19.3 wks : the 17.8 wks in closed fracture ; the 21.6 wks in open fracture ; the 22.3 wks in Non-union. 4) Regardless of amount of comminution, we treated tibial fractures extending from 3 CM distal to the tibial tuberosity to 5 CM above the ankle joint. 5) Static and dynamic interlocking nailing were done 44 and 19 cases respectively. 6) We permitted weight bearing within 2 weeks in butterfly or oblique fracture within 6 weeks in communited or segmental fracture. 7) According to the functional classification of Klemm and 3,orner, among 63 cases, 35 were excellent,20 good,5 fEir and 3 poor.