Journal of Musculoskeletal Trauma

Treatment Using Unreamed Intramedullary Nailing for Open Tibial Fractures: In Heon Park, Ki Byung Lee, Kyung Won Song, Jin Young Lee, Seung Yong Lee; J Korean Soc Fract 1997;10(4):886-891. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.886

Abstract PDF: Intramedullary nailing has become the most popular fixation method in the treatment of the tibial shaft fractures because it affords most rigid fixation of fracture via closed method which makes early rehabilitation possible. Unlearned interlocking nails offer the advantages of loss damage to the intramedullary blood supply, so infectious rate was lower in open fractures compared with reamed nails. We have analyzed 34 cases of 30 patients who performed unlearned interlocking intramedullary nail for open tibial fractures. The results were as follows : 1. The classification of the open fracture was 12 cases Gustilo-Anderson Type I, 20 cases Type II, 2 case Type III. 2. Bony union occured an average of 18 weeks postoperatively. 3. The complication were 4 cases of nonunion, 1 case of deep infection, and 1 case of screw loosening. In conclusion, unlearned intramedullary nailing is a good alternative method for the management of Type I, II open tibial fracture.

Treatment with Unlearned Locked Intramedullary Nail for Open Tibial Fractures: Sang Soo Kim, Byung Chang Lee, Dae Moo Shim, Jae Hoon Shin; J Korean Soc Fract 1995;8(1):284-291. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.284

Abstract PDF: Open fractures of the tibia remain a formidable injury. Which the need for stabillization of open tibial fractures is accepted, the method of fracture stabilization is still controversial because of unacceptable infection rate. External fixation has been the routine and safe procedure for open tibial fractrues. However, this is not without significant complications such as pin tract infection and delayed or nonunion due to insufccient stability. We reviewed the records of 29 patients who underwent immediate unlearned locked intramedullary nailing for open tibial fractures. The average time between injury and operation was 2.4days. The classification of the open fractures was; fifteen Grade I, nine Grade II , and five Grade II a. There was no superficial infections, but one of type III a patient developed deep infection. Skin graft or rotational flap to cover the soft tissue defect were performed. All cases were treated by primary intramedullary nailing without a change of the fixator. So, we think unlearned locked intramedullary nailing is a good alternative method for the management of Grade I, II, III a open tibial fractures.

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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