Comparative study of the locked intramedullary nail and Ender pins in the treatment of tibial diaphyseal fractures.
OBJECTIVE
To compare the locked, unreamed intramedullary nail with Ender pins in the treatment of open Gustilo grade I or II or closed tibial diaphyseal fractures of type A, B, or C2 of the AO classification.


METHODS
Forty-four patients with unilateral tibial diaphyseal fractures were treated with intramedullary nails or Ender pins. Twenty patients were treated with an unreamed intramedullary nail with access via the patellar tendon with static locking. Twenty-four patients were treated with Ender pins introduced medially and laterally with respect to the tuberosity of the tibia. The main parameters analyzed were type of reduction, complications, union rate, deformities, joint mobility, pain, gait, effort capacity, presence of neurovascular disorders, and complaints related to the synthesis material.


RESULTS
During 1 year of follow-up, the fractures of 90.0% of the patients with intramedullary nails and 95.7% of patients with Ender pins healed within an average of 21.5 weeks and 20.9 weeks, respectively. The significant findings were as follows: patients treated with Ender pins had less mobility of the subtalar joint; patients treated with intramedullary nails were more likely to have pain in the knee; both groups showed shortening of the tibia at the end of 1 year of treatment.


CONCLUSIONS
The two methods are similar in the treatment of type A, B, and C2 tibial diaphyseal fractures.
Sakaki
Marcos Hideyo
MH
Department of Orthopedics and Traumatology, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil.
Crocci
Alberto Tesconi
AT
Zumiotti
Arnaldo Valdir
AV
D000328:Adult; D001858:Bone Nails; D018483:Diaphyses / Q000293:injuries / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D011859:Radiography; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome