Treatment of the Fracture of Distal Tibia with the Intramedullary Nailing (Comparison between Ender and Interlocking Nailing)

Ha, Sang Ho; You, Jae Won; Lee, Byoung Ho

Abstract

Authors reviewed 42 fractures of distal tibia fixated with Ender nails(24 cases) or Interlocking nails(18 nails) at the Chosun university Hospital from 1986 to 1992. The purpose of this study is to compare the bony union, the complications and the functional results of two groups(Ender nailing group and Interlocking nailing group). The follow-up period was average 19 months(range, 12 to 36 months). The results were as follows 1. The most common causes of the injury were traffic accidents(36 cases). 2. In the Ender nailing group, 8 cases are closed fractures and 16 cases are open fractures. Among 24 cases, 14 cases are simple fractures and 10 cases comminuted fractures. In interlocking nailing group, 7 cases are closed fracture and 11 cases are open fractures. Among 18 cases, 8 cases are simple fractures and 10 cases are comminuted fractures. 3. The average radiologic union was obtained at 19.3 wks in Ender nailing group, and 18.1 wks in interlocking nailing group. 4. Major complication was a delayed union in both group(5 cases-Ender nailing group, 3 cases-Interlocking group). 5. According to the criteria of functional results by Klemm and Borner, we obtained a 87.5% of Excellent and good results in Ender nailing group(21 out of 24 cases) and 94.4% of Excellent and good results in Interlocking group(17 out of 18 cases). 6. There was no significant difference between the two groups in stable fractures of distal tibia, so we suppose that Ender nailing is a good technique in these cases due to its simplicity and the economic price. But in more unstable fractures such as long oblique, spiral and comminuted fractures, we think that intramedullary interlocking nailing is better due to its stability.