The treatment of tibial fractures by elastic nailing and functional plaster cast

From June 1984 to December 1985, 32 fractures of the tibia were treated by elastic nailing by the Ender method with functional plaster casts according to the Sarmiento method. They represented 28% of all tibial fractures treated during the same period by the traditional conservative method or by external fixators. Elastic nailing was reserved for unstable fractures produced by high velocity trauma. Union occurred in all cases after an average of 13 weeks. Complications were insignificant: shortening by 1.2 cm (1 case); recurvatum (1 case); varus (1 case); valgus (1 case), both less than 8 degrees, and thus within functionally insignificant limits for axial deviation. In one case, a 15 degree internal rotation deformity was corrected after 5 weeks by osteoclasis and fresh elastic nailing which also healed. The advantages of this type of treatment are rapid union and no pseudarthrosis or infection.