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Abstract
Purpose
This retrospective study was conducted in order to evaluate the results of interlocking intramedullary nailing of far distal tibia fractures located within AO classification 43.
Materials and Methods
Seventy patients with far distal tibia fractures in AO classification 43 treated with interlocking intramedullary nailing from May 2008 to April 2012 were evaluated. The minimum follow-up period was 12 months. We analyzed preoperative fracture pattern, associated injury, and complication. All cases were treated with use of either two or three distal interlocking screws during intramedullary nailing. Patients received regular post-operative radiographic check-up and ankle function was evaluated using the Iowa ankle-evaluation rating system.
Results
The fractures healed completely within an average of 18 weeks. None of the patients showed malaligment on the final radiographic evaluation. Average of varus-valgus aligment was 1.9 degrees and average of anterior-posterior alignment was 1.1 degrees. According to the Iowa ankle-evaluation rating system, we obtained satisfactory clinical results in 14 cases. Complication occurred in two cases. There was one case of hypertrophic nonunion and one breakage of the distal locking screw with delayed union.
Conclusion
We consider that interlocking intramedullary nailing of far distal tibia fractures located within AO classification 43 is a considerable method when a plate is not used due to accompanying severe open wound, etc. For satisfactory results, accurate technique and experience of the operator were required.
Figures and Tables
Figure 1
Fluoroscopic X-rays show use of the poller screw for accurate insertion of the nail. Ball tip guide insertion (A), using the poller screw before nail insertion (B), accurate nail insertion at the site (C), distal interlocking screw fixation (D). Postoperative X-ray, anteroposterior (E), and lateral view (F).
Figure 2
A 53-year-old man had a tibia fracture in AO classification 43-A1 after slipping and falling down. Internal fixation with an interlocking nail was performed. Postoperative four-month radiograph shows the healed distal tibia fracture.
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