Distal diaphyseal fractures of the tibia treated by modified Grosse-Kempf nail

Fractures of the distal fourth of tibia are difficult to treat because of the possible involvement of the joint, the comminution of the fragments, the local skin conditions and the surgical method required. There are many methods of osteosynthesis, and these range from external fixation to use of a plate to combined methods. Intramedullary nailing is generally not indicated in the treatment of such fractures, but if the correct technical procedure is used, indications may be widened, and the method may even be used in cases such as these. It is necessary to saw the tip of the nail so that the distal holes go beyond the fracture line. A total of 30 cases of fracture of the distal fourth of the tibia treated by Grosse-Kempf nailing sawed distally are reported.