Intramedullary nailing of proximal quarter tibial fractures.

摘要: Objective: To report the results of intramedullary nailing proximal quarter tibial fractures with special emphasis on techniques reduction. Design: Retrospective clinical study. Setting: Level 1 trauma center. Patients: During a 36-month period, 456 patients shaft (OTA type 42) or metaphysis 41A2, 41A3, and 41C2) were treated operatively at level Thirty-five 37 primarily their formed study group. Thirteen (35.1%) open 22 (59.5%) had segmental comminution. Three intraarticular extensions. Main Outcome Measurements: Alignment reduction postoperatively healing. An angular malreduction was defined as greater than 5 degrees in any plane. Results: Fractures extended proximally to an average 17% length (range, 4% 25%). The distance from articular surface fracture 67.8 mm 17 102 mm, not corrected for magnification, included preoperative planning purposes only). Postoperative angulation satisfactory (average coronal sagittal plane deformity less degree) final angulation. Acceptable alignment obtained 34 (91.9%). Two 5-degree deformities (one varus one valgus), patient 7-degree deformity. associated bone loss underwent planned, staged iliac crest autograft procedure postoperatively. Four lost follow-up. In remaining 31 33 fractures, united without additional procedures. No change radiographic evaluation. Secondary procedures obtain union distal injuries dynamizations (n = 3) exchange 1). Complications deep infections 2 that successfully treated. Conclusions: Multiple required maintain prior attention proper starting point, use unicortical plates, femoral distractor applied tibia. Simple extensions contraindication fixation. healed despite manipulations. Short plate fixations this difficult reduction, either temporary permanent, effective.