Abstract
The nailing of fractures in the distal part of the tibia, even those with intraarticular
extension (certain type A, B1 and C1-fractures of the pilon: AO 43), is possible and
a good alternative to open reduction and plate-osteosynthesis of the tibia. Only the
distal fibula needs an open stabilization. This biological minimally invasive fracture
treatment avoids extensive soft-tissue trauma and problems of wound healing. In a
prospective study spanning two years (from 01.01.2000 until 31.12.2001) 30 fractures
of the distal tibia, stabilized with an intercompression-nail (IC-nail, Stryker),
were analyzed. No soft-tissue problems were seen, only in one case of a second degree
open fracture a postoperative infection developed, which needed five revision operations
with jetting and nail exchange. One rotational malalignment of 15 degrees needed a
corrective osteotomy. Eight fractures (26.6 %) were dynamized after six weeks. In
one case cancellous bone grafting was required. The time of hospitalization of patients
with closed distal fracture treatment was less than nine days. Only in cases with
open fractures or multiple injury a longer stay was necessary.
Key words
Intramedullary nailing - fracture of distal tibia and pilon - intercompression-nail
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Jan M. Vastmans M. D.
Department of Traumatology
Section Spinesurgery
BG-Traumacenter Murnau
Prof. Küntscherstr. 8
82418 Murnau
Germany
Phone: +49/88 41 48 29 38
Fax: +49/88 41 48 21 70
