Intramedullary nailing of unstable diaphyseal fractures of the tibia with distal intraarticular involvement.

Abstract

OBJECTIVE:

To evaluate the efficacy of intramedullary nailing in diaphyseal tibia fractures with distal intraarticular involvement.

DESIGN:

Retrospective.

SETTING:

Henry Ford Hospital, a level I trauma center.

PATIENTS/PARTICIPANTS:

Twenty patients with twenty fractures at an average of twenty-two months of follow-up were evaluated. There were fifteen closed and five open fractures.

INTERVENTION:

All fractures were stabilized with lag screw fixation (with or without supplemental plates) of the intraarticular-fracture extension or ankle fracture, and intramedullary nailing of the diaphyseal tibia fracture.

MAIN OUTCOME MEASUREMENTS:

Time to bony union, malunion, knee and ankle range of motion, early arthrosis, and any complications of treatment were assessed.

RESULTS:

Nineteen fractures healed, with an average time to bony union of seventeen weeks. One nonunion after a grade IIIB open fracture required exchange nailing and healed after sixty-two weeks. Nineteen fractures had excellent alignment after healing. There were no infections.

CONCLUSIONS:

The indications for intramedullary nailing of unstable diaphyseal tibia fractures may be extended to include certain fractures with distal extension into the ankle joint, as well in a tibial shaft fracture occurring in combination with a noncontiguous ipsilateral ankle fracture.

• Authors: G Konrath, B R Moed, J T Watson, S Kaneshiro, D E Karges, K E Cramer
• Journal: Journal of orthopaedic trauma (J Orthop Trauma) Vol. 11 Issue 3 Pg. 200-5 (Apr 1997) ISSN: 0890-5339 [Print] United States
• PMID: 9181504 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Ankle Injuries (etiology, physiopathology, surgery)
• Ankle Joint (physiopathology)
• Diaphyses
• Female
• Fracture Fixation, Intramedullary
• Fractures, Closed (diagnostic imaging, surgery)
• Fractures, Open (diagnostic imaging, surgery)
• Humans
• Male
• Radiography
• Range of Motion, Articular
• Retrospective Studies
• Tibial Fractures (complications, diagnostic imaging, surgery)