Tibial Shaft Fracture: Flexible Nails
A 12-year-old boy sustained an injury to his left leg due to a car accident. Distal neurovascular status of the left lower extremity was intact and the extremity had no open wounds. On radiographic evaluation he was found to have a mid-shaft oblique tibia fracture, with malrotation and shortening. Under fluoroscopy an attempt was made to reduce the fracture; however, the fracture was found to be unstable. Subsequently the patient was taken to the operative room for operative intervention requiring internal stabilization with flexible nailing. He was placed nonweight bearing in a short leg cast for 3 weeks. After radiographs showed adequate healing, he was allowed to weight bear as tolerated for 3 weeks in a camboot. At 6 weeks from surgery with complete union present on radiographs and no pain, he was allowed to fully weight bear as tolerated. Six weeks later, he was evaluated clinically and found to be pain free with full motion; therefore, he was allowed to return to all activities with no restrictions. At 10 months postoperatively, he elected for intramedullary nail removal which was completed without any complications.