Results of Intramedullary Nailing for Distal Metaphyseal Intra-Articular Fractures of Tibia

Abstract

Purpose: This study examined the results of internal fixation using an intramedullary nail in the treatment of distal metaphyseal fractures involving the articular surface. Materials and Methods: From November 2009 to November 2018, distal tibia fractures involving the articular surface were treated with intramedullary nailing only for fractures corresponding to AO type 43 B and 43 C1, twenty-four cases were studied retrospectively. The tibial alignment was measured preoperatively and postoperatively, and the bone union time and nonunion were assessed. In addition, the clinical evaluation of ankle joint function was assessed using the Olerud and Molander ankle score (OMAS). Results: Complete bone union was obtained in all cases, and the mean union time was 17.7±1.87 weeks (range, 15-20 weeks). The average preoperative coronal alignment was 6.4 ° ±1.0 ° (range, 5.2 ° -8.4 ° ), and sagittal alignment was 2.7 ° ±0.6 ° (range, 1.9 ° -3.8 ° ). The average postoperative coronal alignment was 2.5 ° ±0.13 ° (range, 2.2 ° -2.6 ° ) and sagittal alignment was 0.4 ° ±0.25 ° (range, 0.09 ° -0.95 ° ). There was no nonunion. The OMAS had an average of 85±7.9 points (range, 70-95 points). Conclusion: In the treatment of distal metaphyseal fractures involving the articular surface, internal fixation using an intramedullary nail reduces complications and achieves satisfactory reduction and union. This method is considered an excellent treatment to obtain good clinical results.