Clinical Outcomes of the Tibia Segmental Fractures Treated by Intramedullary Nail Using Various Reduction Techniques

Oog-Jin Shon; Ji-Hoon Shin; Chul-Wung Ha

doi:10.12671/jkfs.2013.26.1.50

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Shon, Shin, and Ha: Clinical Outcomes of the Tibia Segmental Fractures Treated by Intramedullary Nail Using Various Reduction Techniques

Original Article

Journal of the Korean Fracture Society

Journal of the Korean Fracture Society 2013; 26(1): 50-55.

Published online: 17 January 2013

DOI: https://doi.org/10.12671/jkfs.2013.26.1.50

Clinical Outcomes of the Tibia Segmental Fractures Treated by Intramedullary Nail Using Various Reduction Techniques

Oog-Jin Shon, M.D., Ji-Hoon Shin, M.D., Chul-Wung Ha, M.D.

Department of Orthopaedic Surgery, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea.

Address reprint requests to: Oog-Jin Shon, M.D. Department of Orthopaedic Surgery, Yeungnam University Medical Center, 170, Hyeonchung-ro, Nam-gu, Daegu 705-717, Korea. Tel: 82-53-620-3640, Fax: 82-53-628-4020, hhahaha1@naver.com

Received 23 June 2012 Revised 6 August 2012 Accepted 6 October 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

We evaluated the clinical outcomes of tibia segmental fractures treated by intramedullary nailing using various reduction techniques.

Materials and Methods

From January 2003 to June 2009, 18 segmental tibial fracture patients treated by intramedullary nail were enrolled with a minimum 12-month follow-up. The mean follow-up was 38 months (range 15-72). According to the AO classification, the fractures were types 42C2.1, 42C2.2, and 42C2.3 in four, ten, and four patients, respectively. Ten fractures were closed and eight were open. We used various techniques for reduction during operation and investigated bone union time and complication (non-union, malunion etc.).

Results

Bone grafting was performed in three patients. Complete union was achieved in all patients. The mean time for union was 16.3 weeks (range 12-21), except in three delayed union patients. All radiological evaluations showed good alignment (less than 5 degree) except in two patients; and the mean deformity angle was 2.2 degree. Knee range of motion (ROM) was 129 degree, and ankle ROM was 68 degree. Local wound infection occurred in two patients.

Conclusion

Intramedullary nailing is a successful method in the acute management of segmental tibial fractures, if accompanied by appropriate reduction technique.

Keywords: Tibia, Segmental fracture, Intramedullary locking nail, Reduction technique

Figures and Tables

Fig. 1

(A) A 54-year-old male patient, segmental tibial fracture.

(B) Initial stabilization of fibula and reduction technique using Steinmann pin.

(C) Union of the fracture 5 months later.

Fig. 2

(A) A 47-year-old male patient, segmental tibial fracture.

(B) Reduction technique using blocking screw.

(C) Union of the fracture 6 months later.

Fig. 3

(A) A 52-year-old male patient, segmental tibial fracture.

(B) Stabilization with a supplemental unicortical plate and expert nail.

Table 1

Summary of Clinical Data

Values are presented as mean or mean (range). ROM: Range of motion.

Table 2

Complications

Values are presented as number (%).

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