Treatment of Tibial Fracture by Interlocking Intramedullary Nailing

Kwon, Chil Soo; Kim, Jin Hyok; Kim, Yong Uck; An, Jong Kuk; Kim, Jin Goo

Abstract

The intramedullary nailing for the tibial fracture has been used in selected cases of fresh diaphyseal fracture and nonunion. However, with modern technical improvement such as image intensifier and interlocking, the indications have been expanded considerably. 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 August, 1989 and July, 1991 interlocking nailing in the tibial fracture has been performed for 53 cases with follow up more than one year. The results were as follows; 1. All were treated with closed nailing and static locking was performed as a principle. Only three cases needed dynamization of the 47 patients treated with static locking nailing. 2. The union rate was 96.296 and mean period of fracture union was 15.2 weeks. 3. In the distal one third of fracture, rigid fixation could be achieved by adjusted length by cutting the distal end. 4. In 7 proximal tibial fractures, 4 fractures were accompanied with complications such as nonunion, angulation deformity and shortening. Therefore, interlocking nail is inadequate treatment of proximal unstable fractures. 5. In the delayed and nonunion treated by interlocking nailing, bony union was achieved in all 3 cases without bone graft and cast immobilization.