Abstract
Concomitant ipsilateral femoral and tibial fractures present a challenging therapeutic problem. They are generally caused by high-energy trauma, primarily motor-vehicle accidents, and the associated injuries frequently develop. Also the complications much as delayed union, non-union, malunion and stiffness of the knee are more prevalent in patients with this combination of fractures than in patients with an isolated femoral or tibial fractures.
The interlocking nail system has many advantages about among the many treatment methods of isolated long bone fractures, but the surgical technique is very difficult at the concomitant ipsilateral femoral and tibial fractures. The purpose of this study has been to review the surgical technique and to grasp an easy reduction method at that fractures.
We routinely perform the interlocking nail for the ipsilateral femoral and tibial fractures in order to promote early motion of the knee in 14 patients from 1989 to 1995.
Local complications included 1 case of femoral metal failure, and 2 cases of nonunion treated by bone graft. At the last follow up examination, at an average of 13 months after injury, the mean range of motion of the knee was 130 degrees. Over-all, a good or excellent functional result was achieved in about 93% of the patients according to the criteria suggested by Karlstr m and Olerud.
In conclusion, the best results were achieved when both fractures were stabilized surgically with the interlocking nail system.