[Assisting plate with reamed intramedullary nailing for segmental fractures of proximal-middle tibia]

To evaluate the efficacy and safety of combining reduction plating with reamed intramedullary nailing for segmental fractures of proximal-middle tibia.

From June 2007 to October 2011, 31 patients with segmental fractures of proximal-middle tibia were admitted. There were 18 males and 13 females, with an average age of 45.2 years (range: 23-77 years), of whom, 9 were Gustilo I type open fractures and 22 were close fractures. All the patients were treated with assisting plate combined with reamed intramedullary nailing. The operation was performed averagely 35 h (range: 16-72 h) after injury. During the post-operation follow-up radiographic evaluation, the range of knee joint, and Johner-Wruhs scores were measured.

All the patients were followed-up for 18.5 months (range: 17-24 months). No wound infection or osteofascial compartment syndrome happened. All the fractures healed after 5.1 months (range: 4-6 months). The proximal and distal fracture sites healed simultaneously. No malunion was found. In the last follow-up, the mean range of knee joint was 9°-0°-127°, and according to Johner-Wruhs scores, 19 were excellent, 10 good, and 2 fair.

Assisting plate with reamed intramedullary nailing is a safe and effective alternative choice for segmental fractures of proximal-middle tibia, which can ease the difficulty of the procedure, improve the quantity of reduction and enhance the stability of the hardware.