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KMID : 0386420140270020144
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Journal of the Korean Fracture Society
2014 Volume.27 No. 2 p.144 ~ p.150
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Intramedullary Nailing of Distal Tibial Fractures with Percutaneous Reduction by Pointed Reduction Forceps
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Hwang Jae-Kwang
Kim Chung-Hwan
Choi Young-Joon
Lee Gi-Won
Lee Hyun-Il
Kim Tae-Kyung
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Abstract
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Purpose: The purpose of this study is to analyze the radiographic and clinical results of intramedullary nailing after percuta-neous reduction using pointed reduction forceps for spiral or oblique fractures of the distal tibia. The benefit of percutaneous reduction using pointed reduction forceps in anatomical reduction and maintenance was assessed.
Materials and Methods: From January 2005 to December 2009, 47 cases of distal one-third tibial fracture were managed by intramedullary nailing using pointed reduction forceps. Thirty-eight cases were spiral fracture and nine cases were oblique fracture. In all cases, the percutaneous reduction was achieved using pointed reduction forceps under fluoroscopy control. While maintaining the reduction with the pointed reduction forceps, the intramedullary nail was inserted. The pointed reduc-tion forceps were removed after insertion of proximal and distal inter-locking screws. Alignment was evaluated with ante-rior-posterior and lateral radiographs taken immediately post-operation and at the time of union.
Results: At immediate post-operation, the mean displacement of valgus and anterior angulation was 0.57o and 0.24o, respectively. That of valgus and anterior angulation at bone union was 0.37o and 0.16o, respectively. The average duration of bone union was 16.1 weeks.
Conclusion: Intramedullary nailing with percutaneous reduction using pointed reduction forceps for distal tibial fractures was an easy and effective method for achievement of accurate alignment intra-operatively. Accurate alignment was successfully maintained until bone union.
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KEYWORD
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Distal tibial fractures, Intramedullary nailing, Percutaneous reduction
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