Comparison of Crosse-Kempfs versus Brookers Interlocked Nailing for the Tibial Fracture

You, Jae Won; Lee, Byoung Bo; Park, Jin Suk

Abstract

Recently, Intramedullary nailing has become the most common method treating tibial fractures. Various patterns of intramedullary nails are now being developed and using. The purpose of this study is to compare the clinical results, merits and defects of Blocker interlocked nails with Grosse-Kempf(G-K) interlocked nails and to recommend the appropriate nail according to the type and location of the tibial fracture. The authors analysed 62 cases(G-K nail, 34cases; Brooker nail, 28 cases) of tibial fractures which were treated at Chosun university hospital and Sun Cheon hospital between 1991 and 1993. The results were as follows; 1. The average operation time was 62 minutes for G-K interlocked nailing and 35 minutes for Brooker interlocked nailing. 2. In segmental fractures involving the proximal shaft or in proximal shaft fractures, all cases treated with a C-K nail had good results, but 3 of the 8 cases treated with Blocker nail showed angular deformity. 3. In distal shaft fractures, especially fractures with poor soft tissue coverage or within 6cm of the distal tibial end, it was difficult to insert the two distal locking screws of the G-K nail. 4. The complications associated with G-K nails were deep infection(2 cases), nonunion(1 case), loosening and breakage of locking screw(3 cases), and limitation of knee motion(3 cases). The Complications associated with Brooker nails were deep infection(1 case), uonunion(1 case), loosening and breakage of locking screw(2 cases), limitation of knee motion(2 cases), and angular deformity(3 cases). 5. According to Klemm and Boner criteria for functional result, 88% of G-K nail and 89% of Brooker nail fell into good or excellent categories. In conclusion, we recommend G-K nailing in segmental fractures involving the proximal shaft or proximal shaft fractures and the Brooker nailing in distal shaft fractures.