JORT Journal

Abstract

Objective: To Investigate the efficacy of elastic intramedullary nail combined with screw in the treatment of tibial fracture and distal tibial epiphysis fractures in Adolescents. Methods: A total of 8 typical cases were reviewed in our hospital medical record system from January 2014 to January 2022. There were 7 males and 1 female; The age distribution was 13-16 years old. The injuries were as follows: 3 cases of accidental sprain while playing basketball, 1 case of falling into a gutter while riding a bicycle, and 4 cases of falling from a height of 2 meters. There were 6 cases of right lower limb and 2 cases of left lower limb. The surgical methods were elastic intramedullary nail fixation for tibial fracture and screw fixation for distal epiphyseal fracture of tibia. Full length anterior-lateral radiographs of the tibia and fibula were taken at the 1st, 6th, 12th, and 6th and 9th months, respectively. To observe the fracture alignment and healing. The American orthopaedic foot and ankle society AOFAS Ankle-Hindfoot Scale AHS, fracture healing and other complications were recorded at the last follow-up. Results: All patients completed the follow-up (12 months). At the last follow-up (12 months after operation), all patients achieved bone healing, the healing time was 6-9 months, and there were no complications such as osteofascial ventricle syndrome, wound infection, internal fixation rupture, malunion, and limb unequal length. The American orthopaedic foot and ankle society Ankle-Hindfoot Scale is: 91-100.All the 8 cases were rated as excellent. Conclusion: When the tibial fracture is found in older children, especially the tibial fracture line is long oblique or spiral, it is important to examine the distal tibial epiphysis, and CT should be performed if necessary to further confirm the diagnosis. The elastic intramedullary nail combined with screw can obtain satisfactory results.

Keywords: Tibial fracture; Fracture of distal tibia; Fracture internal fixation.