[Early results of treatment with expandable intramedullary nails in tibia shaft fractures]

We evaluated the use of expandable intramedullary nails, their efficacy, and short-term results in the treatment of tibia shaft fractures.

The study included 19 patients (8 females, 11 males; mean age 38 years; range 17 to 65 years) who were treated with expandable intramedullary nails (Fixion) for tibia shaft fractures. All the fractures were closed. Four patients had associated injuries. According to the AO classification, the fractures were type 42-A, B, or C. The mean duration from injury to surgery was 2.8 days (range 6 hours to 14 days). The results were evaluated using the Johner-Wruhs criteria. The mean follow-up was 23 months (range 9 to 39 months).

The mean operation time was 47 minutes (range 25 to 53 min). Union was achieved in all the patients in a mean of 11.5 weeks (range 8 to 18 weeks). According to the Johner-Wruhs criteria, the results were excellent in 17 patients (89.5%) and good in two patients (10.5%). Treatment of fragmented-oblique fractures of the distal metadiaphysis (42-B2) resulted in a valgus angulation of 5 degrees in two patients, and extremity shortening of 5 mm in one patient, both of whom had good results. Complications such as delayed union, early or late infections, or bone necrosis did not occur. The range of motion of the knee and ankle reached that of the contralateral side in all the patients.

Expandable intramedullary nails offer advantages in terms of ease of application and are less invasive than static nails and reamed applications. However, they may not provide adequate stability in fractures with fragments greater than 50%.