Abstract
We reviewed 18 patients, 14 with acute fractures and four with non-union of the distal tibia, treated between 1990 and 2001 with a shortened, reamed intramedullary nail. The mean follow-up was 38 (8–144) months. The fractures united at an average of 16 (12–18) weeks and the non-unions at 20 (12–30) weeks. Two patients required nail dynamization. No limb shortening nor material failures were seen. All patients returned to normal daily activities. Although technically demanding, intramedullary nailing for distal tibial fractures and non-unions with a shortened nail represents a safe and reliable method.
Résumé
Nous avons revus 18 malades, 14 avec une fracture récente et quatre avec une pseudarthrose tibial distale, traité entre 1990 et 2001 avec un clou intramédullaire court placé après alésage. Le suivi moyen était de 38 mois (8–144) . Les fractures ont consolidé à une moyenne de 16 (12–18) semaines et les pseudarthroses à 20 (12–30) semaines. Deux malades ont nécessité une dynamisation du clou. Il n'y a pas eu de raccourcissement de membre ni d'ennuis de matériel. Tous les malades ont retrouvé des activités journalières normales. Bien que difficile techniquement, l'enclouage intramédullaire distal avec un clou court représente une méthode sûre et fiable.
Similar content being viewed by others
References
Bonnevialle P, Savoti L, Combes JM, Rongieres M, Bellumore Y, Mansat M (1996) Value of intramedullary locked nailing in distal fractures of the tibia. Rev Chir Orthop Reparatrice Appar Mot 82: 428–436
Court-Brown CM, Christie J, McQueen MM (1990) Closed intramedullary tibial nailing: its use in closed and type I open fractures. J Bone Surg [Br] 72:605–611
Dogra AS, Ruiz AL, Thompson NS, Nolan PC (2000) Dia-metaphyseal distal tibial fractures—treatment with a shortened intramedullary nail: a review of 15 cases. Injury 31:799–804
Duda GN, Mandruzzato F, Heller M, Goldhahn J, Moser R, Hehli M, Claes L, Haas NP (2001) Mechanical boundary condition of fracture healing: borderline indications in the treatment of undreamed tibial nailing. J Biomech 34:639–650
Gorczyca JT, McKale J, Pugh K, Pienkowski D (2002) Modified tibial nails for treating distal tibia fractures. J Orthop Trauma 16:18–22
Kneifel T, Buckley R (1996) A comparison of one versus two distal locking screws in tibial fractures treated with undreamed tibial nails: a prospective randomized clinical trial. Injury 27:271–273
Konrath G, Moed BR, Watson JT, Kaneshiro S, Karges DE, Cramer KE (1997) Intramedullary nailing of unstable diaphyseal fractures of the distal intra-articular involvement. J Orthop Trauma 11:200–205
Moscato M, Sabetta E, Tigani D, Mignani G, Specchia L, Boriani S (1991) Grosse-Kempf nailing in fractures of the tibia. Ital J Orthop Traumatol 17:313–320
Robinson CM, McLaughlan GJ, McLean IP, Court-Brown CM (1995) Distal metaphyseal fractures of the tibia with minimal involvement of the ankle. Classification and treatment by locked intramedullary nailing. J Bone Joint Surg [Br] 77:781–787
Trafton GG (1998) Tibial shaft fractures. In: Skeletal Trauma, Browner BD, Levine AM, Jupiter JB, et al (eds) Saunders, Philadelphia
Tyllianakis M, Megas P, Giannikas D, Lambiris E (2000) Interlocking intramedullary nailing in distal tibial fractures. Orthopedics 23:805–808
Whittle P, Crates J, Wood GW, Duncan S (1997) Distal-fourth tibia fractures treated with locked intramedullary nailing: Does fibular fracture influence malalignment? OTA, Annual Meeting, Louisville, KY, USA p. 43
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Megas, P., Zouboulis, P., Papadopoulos, A.X. et al. Distal tibial fractures and non-unions treated with shortened intramedullary nail. International Orthopaedics (SICOT) 27, 348–351 (2003). https://doi.org/10.1007/s00264-003-0499-9
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00264-003-0499-9