Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Trauma - Tibia/Fibula
Abstract number: 26605
INTRAMEDULLARY NAILING OF DISTAL TIBIAL FRACTURES LOCATED
WITHIN 5 CM OF THE ANKLE JOINT
GANAPATHY RAMAN PERIANAYAGAM, RAJAT VARMA
Kings College Hospital, London, LONDON (UNITED KINGDOM)
Background: Treatment of distal tibial fractures located within 5 cm of the ankle joint
has always been controversial. In this study we have evaluated the results of
intramedullary nailing of distal tibial fractures located within 5 cm of the ankle joint.
We have also discussed our decision making in the treatment of these fractures
using illustrative cases to show our indications for intramedullary nailing, our
techniques to obtain closed reduction using polar wires and the need for built in
compression in the construct to promote collapse at the fracture site and thus aid
fracture healing.Methods: A retrospective study looking at 26 fractures over a three
year period that involved the distal 5 cm of the tibia being treated with intramedullary
nailing. These fractures were classified according to AO classification.6 fractures with
intrarticular extension needed closed reduction using polar wires and supplementary
screw fixation to achieve anatomical reduction before nailing. We included both
closed and open fractures.Results: Good anatomical reduction was achieved and
maintained in 16 of the 18 patients. Acceptable radiographic alignment defined as <
5° of angulation in any plane was achieved in 92 % of patients. . All fractures healed
clinically and radiologically at an average of 17 weeks. 11 patients were able to
mobilise independently without pain by the end of 3 months. Average hospital stay
was less than 1 week. Conclusion: Intramedullary nailing is an effective alternative
method in the treating both closed and open distal tibial fractures as well as those
fractures with articular extension.
615