Journal of Musculoskeletal Trauma

Treatment of Open Type-III Tibial Shaft Fractures -Comparison Between Ilizarov External Fixation and Secondary Intramedullary Nailing-: Hoon Kim, Woo Dong Nam, Ki Chan Ahn, Seung Seok Seo, Young Chang Kim, Jang Seok Choi, Young Goo Lee; J Korean Soc Fract 1998;11(1):191-197. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.191

Abstract PDF: Open type III tibial shaft fractures have a high incidence of complication and a poor outcome. The most usual method of stabilization is by external fixation, but there are several complications as infection, delayed union and nonunion. We tried to compare the results of Ilizarov external fixation cases with the case of secondary intramedullary nailing after temporary Ilizarov fixation. There was no significant difference in the union time of Ilizarov external fixation and secondary intramedullary nailing after temporary Ilizarov fixation. But the patients were more comfortable in the secondary intramedullary nailing. In conclusions, secondary intramedullary nailing after temporary Ilizarov fixation is the useful method in the treatment of open type III tibial shaft fractures.

Treatment using Intramedullary Fixation for Open Tibial Diaphyseal Fractures: Young Goo Lee, Jnng Seok Choi, Young Chang Kim, Hyun Duck Yoo, Seung Seok Seo, Sang Hun Ha; J Korean Soc Fract 1996;9(3):583-592. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.583

Abstract PDF: This fractures of tibial shaft are common and open injuries are frequently accompanied due to its anatomical characteristics. External fixation was widely used for treatment of open fractures of tibia, but recently internal fixation combined with appropriate debridement and antibiotics has been reported, with more comfortness and less secondary operations. We analysed 33 cases of open tibial diaphyseal fractures treated using intramedullary fixation devices. The results were as follows. 1. The methods of fixation were Ender nail, 15 cases, and interlocking nail, 18 cases. And 17 cases out of 18 interlocking nail were unlearned one. 2. The Ender nail was used in 5 cases for open type I fracture, 7 type II, 2 type III-a and 1 type III-b, And the interlocking nail was used in 9 cases for type 1, 7 type II, 1 type IIIa and 1 type III-b. The average operation time was 55 minutes for Ender nail, while 14 minutes for interlocking nail. 3. The Ender nailing group has 6 complications;one case superficial infection, one deep infection, one delayed union, one nonunion and two angulation deformities. The interlocking nailing group has also 6 complications;one case superficial infection, two deep infections, one delayed union, one nonunion and one peroneal nerve palsy. 4. The average union period was 18.4 weeks in Ender nail and 19.1 weeks in interlocking nail.

Treatment of the Tibia Shaft Fractures with Unreamed Intramedullary Interlocking Nail: Ki Chan Ahh, Seung Seok Seo, Hyun Duek Yoo, Jang Seok Choi; J Korean Soc Fract 1994;7(1):95-104. Published online May 31, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.1.95

Abstract PDF: In general, blood supply of the long bones contributes three ways-nutrient, metaphyseal and periosteal vessels. Its vascular damage is caused by major trauma or extensive soft tissue det-achment. When the diaphysis of long bone is reamed, endosteal blood supply is eliminated. In our hospital, 23 selected cases of the diaphyseal fracture of tibla have been treated by manipulative reduction, unlearning of the medullary canal and fixation of fracture fragments with an Interlocking intramedullary nail for preserration its vascularity as possible. We analized the patients from Jan. 1992 to May 1993, who were followed up for a mean 12 months. Most of cases were acute, 18 of these cases were open fracture and main cause of the injury was traffic accidents. Overall, 90% of the patients were judged to have good or excellent result based on both clinical and radiological parameters, and the average bony union time was 17 weeks. The complications were mainly infection(3 cases), loosening or breakage of the locking screws(3 cases) and delayed union(1 case). The merits of unlearned interlocking nailing were relatively easy procedure, short operation time, decreased complcations, rigid fixation and early rehabilitation. We concluded that unlearned intramedullary interlocking nailing is a useful method to treat the tibia shaft fractures, especially open type.

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