Osteosynthesis and Trauma Care 2003; 11(1): 24-28
DOI: 10.1055/s-2003-40122
Original Article

© Georg Thieme Verlag Stuttgart · New York

Intramedullary Nailing with a Modified Nail and Alterations of the Operative Technique for the Management of Type A Pilon Fractures of the Tibia: A Prospective Study

C. Garnavos1 , T. Balbouzis1 , E. Papangeli1 , K. Stavropoulos1 , C. Giannoulatos1 , N. Kanakaris1 , A. Mitseas1
  • 11st Orthopaedic Department of ”Evangelismos” General Hospital, Athens, Greece
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Publikationsverlauf

Publikationsdatum:
20. Juni 2003 (online)

Abstract

Eleven patients who sustained Pilon type A (according to AO classification) closed tibial fractures were treated with a modified G-K tibial nail. Two patients had sustained severe soft tissue damage around the ankle. The nail to be used was pre- selected by studying the X-rays of both the injured and the uninjured tibia. Subsequently, the nail was modified by cutting 1 to 1.5 cm off the distal end and creating an additional hole in between the pre-existing two distal holes. In this way it was possible for, at least, two screws to be inserted distal to the fracture line. The operative technique was also modified to accommodate the technical difficulties encountered during the first two cases. Poller screws were used in two cases. There were no intra- or post- operative complications. All fractures united soundly from 14-20 weeks. The patients regained full range of motion of the ankle joint and returned to the pre-fracture level of activity. Intramedullary nailing can provide a reliable treatment option for the type A Pilon fractures of the tibia. Alterations of the operative technique are necessary for a successful result.

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Dr. Christos Garnavos

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Athens · Greece

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