Comparison Study Between Rush Nailing and Ender Nailing in the Treatment of Fracture of the Tibial Shft

Lee, In Ju; Moon, Myung Sang; Chang, Ju Hai; Cha, Sang Hoon

Abstract

Fracture of the tibial shaft is one of the most common fracture of the long bones and, due to its frequency and easy accessibility to traumatic insults, it is frequently complicated with malunion, delayed union and nonunion, and osteomyelitis. Recently, closed flexible intramedullary nailing of the fracture of the long bones has gained popularity. And its application to the tibial shaft fracture is reported to meet the object of fracture treatment by providing maintenance of reduction and by allowing early mobilization of the injured leg. There are other advantages such as stimulation of forming external callus by allowing some motion at fracture site, adequate fixation without exposure of the fracture site. Authors carried out retrospective study of the 56 tibial shaft fractures in 54 patients which were fixed with Rush nails (31 tibial fracture in 30 patients) or Ender nails (25 tibial fractures in 24patients). The results were analyzed to compare the effectiveness of these two methods. The results were as follows: 1. Tibial fracture treated with rush nailing united clinically at 15.7 weeks and united radiologically at 21.8 week on an average postoperatively. 2. There was a tendency of earlier healing of fracture of tibial shaft treated with Ender nailing:clinical union and radiological union were obtained at 12.8 weeks and 18.8 weeks on an average, respectively. 3. Ender nailing has advantage such fracture fragment during insertion. 4. Additional insertion of Ender nail as ease of nailing, low incidence of displacement of undisplaced provided greater stability at the fracture and it was attributable to earlier healing of tibial fracture treated with Ender nailing. 5. Rush and Ender nailings failed to maintain reduction of the fracture of proximal tibia shaft. As the advantages of Ender nailing surpass those of Rush nailing, authors have preference of Ender nailing in the treatment of the tibial shaft fracture.