Flexible intramedullary nailing of tibial-shaft fractures.

Closed flexible intramedullary nailing was used in 38 fractures of the tibia shaft. Simple transverse, oblique, or spiral fractures were shown to be stable after nailing. Fractures with a large unicortical butterfly fragment, involving more than one-third of the cortex, had a tendency to angulate. There were 23 fractures in the distal third of the tibial shaft; nine in the middle third; and four in the proximal third. The operations were simple and quick, lasting an average of 38 minutes. Sixteen patients used a short walking cast, usually for periods of four to six weeks. The cast was usually applied for comfort. The average healing time was 14.3 weeks. There were three cases of delayed and nonunion. In one patient, significant increase in valgus deformity occurred and required a renailing procedure. There was one case of osteomyelitis in a patient who had a Grade 3 open tibial fracture, which was debrided with a considerable delay.

[1]  A. Pankovich.  Adjunctive fixation in flexible intramedullary nailing of femoral fractures: a study of twenty-six cases. , 1981, Clinical orthopaedics and related research.

[2]  E. Eriksson,et al.  Ender nailing in fractures of the diaphysis of the femur. , 1979, Journal of Bone and Joint Surgery. American volume.

[3]  R. Pearson,et al.  Closed Ender nailing of femoral-shaft fractures. , 1979, The Journal of bone and joint surgery. American volume.

[4]  E. Dehne.  Ambulatory treatment of the fractured tibia. , 1974, Clinical orthopaedics and related research.

[5]  S. Olerud,et al.  Fractures of the tibial shaft; a critical evaluation of treatment alternatives. , 1974, Clinical orthopaedics and related research.

[6]  R. M. D'aubigne,et al.  Blind intramedullary nailing for tibial fractures. , 1974, Clinical orthopaedics and related research.

[7]  L. Anderson,et al.  Fractures of the Tibia and Fibula Treated with Casts and Transfixing Pins , 1966, Clinical orthopaedics and related research.

[8]  J. Zucman,et al.  Two-level fractures of the tibia. Results in thirty-six cases treated by blind nailing. , 1969, The Journal of bone and joint surgery. British volume.

[9]  P. Brown,et al.  Early weight-bearing treatment of open fractures of the tibia. An end-result study of sixty-three cases. , 1969, The Journal of bone and joint surgery. American volume.

[10]  A. Sarmiento,et al.  A functional below-the-knee cast for tibial fractures. , 1967, The Journal of bone and joint surgery. American volume.

[11]  J. Wickstrom,et al.  Evaluation of Intramedullary Fixation of the Tibia with the Lottes Nail , 1960, Southern medical journal (Birmingham, Ala. Print).