Surgical treatment of bilateral tibial fracture with interlocking intramedullary nail and/or AO external fixator / 中国矫形外科杂志

ABSTRACT

Objective To evaluate the clinical value and relating problems in treating bilateral tibial fracture by using interlocking intramedullary nail and/or AO external fixator.MethodTotally 33 patients of bilateral tibial fracture treated with interlocking intramedullary nail and/or AO external fixator from April 1998 to January 2006 were retrospectively reviewed.There were 26 males,7 females,with an average age of 34.4 years.According to the AO/ASIF classification,there were type A 9 limbs,type B 13 limbs and type C 17 limbs.According to Gustilo classification there were type Ⅰ 10 limbs,type Ⅱ 6,ⅢA 5,type ⅢB 4 and type ⅢC 2.Duration from injury to operation was 5.5 days(3 hour～12 days). ResultAll patients were followed up for 6～36 months,with the average time being 16 months.All fractures had bon union.The union time averaged 16 weeks in closed fractures and 18 weeks in open fractures.Delayed union occurred in 4 limbs.There were 3 limbs of superficial infection.The results were excellent in 19 cases,good 11 cases,fair 3 cases according to the criteria of Johner-Wruh.Rate of excellent and good result was 90.9%.No fat embolism syndrome,deep in fection,failure of fixation and malunion were not found in this group.ConclusionThe advantages of interlocking intramedullary nail and/or AO external fixator in treatment of bilateral tibial fracture has advantages of easy performance,reduced destruction of blood supply to the fracture ends,rigid fixation,high union ratio of fractures,promotion of early functional extercise and satisfactory effect.The selection of the fixation device should be adopted according to the types of the fracture.