Journal of Musculoskeletal Trauma

Thermal Injury Complicating Improperly Reamed Intramedullary Nailing of the Tibia: A Case Report: Bo Kun Kim, Hyun Dae Shin, Jung Mo Hwang; J Korean Fract Soc 2011;24(2):178-184. Published online April 30, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.2.178

Abstract PDF: Endosteum and bone marrow thermal necrosis caused by reaming during tibial intramedullary nail insertion, and unskilled operation of soft tissue penestration by reamer resulted in chronic osteomyelitis and soft tissue defect. So, several times of free flaps were done but the result was unsuccessful. At last, the authors performed radical necrotic bone resection and internal bone transport using Ilizarov external fixator. The authors report case with literature review.

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Treatment of Tibial Shaft Fractures Using Interlocking Intramedullary Comparison of Reamed and Unlearned Methods: Woo Nam Moon; J Korean Soc Fract 1997;10(3):562-568. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.562

Abstract PDF: Sixty-four closed or Gustilo type I open fractures of the tibial shaft were treated with interlocking intramedullary nailing with(n=38) or without(n=26) reaming and were followed for an average of 13 months. The time to bony union ranged from twelve to twenty-five weeks with an average of 16.4 weeks in reamed method and from thirteen to twenty-seven weeks with an average of 15.9 weeks in unlearned method. The complications of reamed method were seen in 4 cases(11%) (two stiffness of ankle joint, one malunion and one distal screw breakage) whereas complications of unlearned method were seen in 7 cases(27%) (one stiffness of ankle joint, two malunions and four distal screw breakages). There was no significant difference in the union time of reamed and unlearned interlocking intramedullary nailing. But complications of fracture healing were less frequently seen on reamed interlocking intramedullary nailing.

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Tibial Segmental Fracture Treated with Interlocking Intramedullary Nail: Churl Hong Chun, Byung Chang Lee, Gyu Taec Hwang, Soon Gu Kwon, Han Sol Lee; J Korean Soc Fract 1997;10(3):534-540. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.534

The orthopaedic surgeon experiences the difficulties of treating segmental tibial fractures by internal fixation and accompanying complications. OBJECT : The purpose of this study has been to review the useful treatment of 21 interlocking nails in the tibial segmental fracture, to investigate the union rate related to fracture types and to analyze the complications related to it. METERIAL and METHOD : Between November 1988 and August 1995, the authors treated tibial segmental fractures with interlocking intramedullary nail and analyzed 21 cases with followed up of more than 1 year. Injury mechanism were caused by traffic accident in which high velocity accounted for 17 cases. 11 cases of segmental tibial fracture were closed, and 10 cases were open. 6 cases of open fracture were open type 1, and 4 cases were open type II. We treated 21 fractures with unlearned intramedullary nail of 7 cases and limited reamed intramedullary nail of 14 cases.
RESULT
: Callus formation and consolidation were faster at the posterolateral aspect of the tibia than in anteromedial aspect. Radiologically complete union was faster in proximal portion at average 26.8 weeks than distal portion of segmental fracture at average 35.6 weeks. Complications included 2 cases of nonunion, 1 infection, 2 screw breakage and 2 ankle joint stiffness.
CONCLUSION
: We achieved excellent results using interlocking intramedullary nail by limited reaming or unlearned methoo in the tibial segmental fracture even though the injury was caused by high-velocity external force.

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Outcomes and Analysis of Factors Affecting Bone Union after Interlocking Intramedullary Nailing in Segmental Tibia Fractures
Sang Soo Park, Jun-Young Lee, Sang-Ho Ha, Sung-Hae Park
Journal of the Korean Fracture Society.2013; 26(4): 275. CrossRef

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