Treatment of Distal 1/3 Fracture of Tibia by Intramedullary Nailing

Lee, Eun No; Yu, Chang Moo; Lee, Suk Ha; Lee, Sung Jong; Kim, Taik Seon; Shim, Jae Ik

Abstract

Recently, there is seen frequently the tibial fracture due to the increased traffic accident and the high energy trauma, and this fracture has many problems in a treatment because of nonunion, malunion, angular deformity, shortening and infection. In the treatment of distal 1/3 fracture of tibia. interlocking intramedullary nailing has been popularized because it enables preservation of the range of motion of the joint, early weight bearing and early bony union. Between Jan. 1988 and Dec. 1993 intramedullary nailing of the tibial fracture has been perfomed in 41cases, of which 38 cases were acute fractures and 3 cases were nonunion with folow up of more than one year. The results were as follows; 1. Closed nailing technique was accomplished in 38 cases and 3 were opened. 2. The mean fracture healing period was 18.6 weeks and each mean fracture healing time was 19 weeks in Brooker nail and 18.5 weeks in interlocking nail, and so there was no significant difference in bone union time between two devices. 3. According to the functional classification of Klemm and Borner, out of 41 cases,26 were excellent,8 were good,5 were fair and 2 were poor. 4. The complications were infection in 4 cases, delayed union in 2 cases, angular deformity in 1 case and partial ankylosis of knee in 1 case. 5. In the cases associated with soft tissue injury and comminuted fracture of distal 1/3 of lower leg, Blocker nail was considered an useful treatment when distal interlocking screw fixation was not appropnate.