Evaluation of the technique of blocking screw on treatment of fractures of the distal third of the tibia | ||||
| The Egyptian Orthopaedic Journal | ||||
| Volume 47, Issue 3, September 2012, Page 315-320 PDF (566.39 K) | ||||
| DOI: 10.7123/01.EOJ.0000418008.02489.59 | ||||
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| Authors | ||||
| Nehad El Mahboub; Nagy Sabet | ||||
| Abstract | ||||
| Background Treatment of fractures of the distal third of the tibia is still controversial. Open reduction and internal fixation with plates and screws allow axial stability but may increase the risk of soft-tissue complications and lead to loss of the fracture hematoma, which is valuable in fracture healing. Closed interlocking nailing avoids soft-tissue complications and preserves the fracture hematoma, but the wide and short distal metaphyseal segment makes the fracture amenable to varus and valgus deformity. Patients and methods Twenty patients with 20 closed fractures of the distal third of the tibia underwent closed interlocking nailing and application of a blocking screw in Misr University for Science and Technology Hospital from January 2006 to January 2009. Their ages ranged from 20 to 55 years. The cause of injury was road traffic accidents in 12 cases and falls in eight. The time from injury to operation varied from 2 to 21 days. The patients were evaluated clinically and radiologically and the results were evaluated according to the Olerud and Molander scoring system. Results All patients revealed bone union at the final follow-up period; one patient underwent a second procedure for bore grafting and a sound union was achieved. Dynamization by removing the two proximal locking screws was performed in two cases to facilitate bone union. According to the Olerud and Molander scoring system, 10 cases were excellent, nine cases were good, and one case was fair; no cases of poor results were observed. No cases of limb-length discrepancy, malalignment, nail propagation into the ankle, or screw breakdown were found. All patients returned to routine daily activities after fracture healing. Conclusion Closed interlocking nailing with the application of a blocking screw is an effective method for the treatment of fractures of the distal third of the tibia; it provides axial stability, prevents shortening, varus, or valgus deformity, and avoids soft-tissue complications. | ||||
| Keywords | ||||
| Blocking screw; Distal tibia; Interlocking Nail | ||||
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