[Treatment of distal metaphyseal fractures of the tibia with the interlocking flexible osteosynthesis system]

Accurate anatomic identification of distal metaphyseal fractures of the tibia is necessary when comparing the fixation ability of internal fixation devices. First, we have set the dimensions of the metaphyseal area. The purpose of this study was to evaluate the Interlocking Flexible Osteosynthesis system in properly selected distal metaphyseal fractures, not to be confused with distal shaft fractures.

This study involves 28 fractures, including 10 diaphyseal-metaphyseal fractures, and 18 pure metaphyseal fractures, 9 of which were distal fractures involving the inferior half of the metaphysis. Five of them were segmental fractures.

There were 5 severe complications: early loosening (1), nonunions (2), severe malalignments in 2. These resulted from a combination of insufficient distance between the tips of pins, with severe demineralization of bone tissue. The authors have emphasized the technical means available to avoid this. Twenty-five fractures united at a mean of 13.5 +/- 5 weeks (all types).

Such a fixation is reliable as long as certain technical rules are respected, which requires a great deal of experience with the method.