title: [Expert tibial nails in treatment of complex tibial fractures of type C].
abstract: OBJECTIVE
  To study the clinical effect of expert tibial nail (ETN) in the treatment of the complex tibial fractures of type C.
  
  
  METHODS
  From May to October 2008, 10 cases of complex tibial fractures of type C were treated with unreamed ETN and closed reduction. There were 7 males and 3 females aging from 23 to 50 years with an average age of 39 years. Fracture was caused by traffic accident in 6 cases, by crush in 2 cases, and by falling from height in 2 cases. According to Association for the Study of Internal Fixation (AO/ASIF) classification, there were 2 cases of 42-C1 fractures, 4 cases of 42-C2 fractures, and 4 cases of 42-C3 fractures; including 4 cases of closed fractures and 6 cases of open fractures (2 cases of Gustilo type I and 4 cases of Gustilo type II).
  
  
  RESULTS
  The mean duration of surgery and blood loss were 75 minutes (range, 60-110 minutes) and 55 mL (range, 20-100 mL), respectively. All the incision healed by first intension without complication of infection. All cases were followed up for 12-17 months (average 14 months). X-ray films showed that no breakage of nail, iatrogenic fracture, limb shortening, and angulation deformity occurred. All fractures healed after 3-8 months (average 4.2 months). At last follow-up according to Johner-Wruhs standard for the functional recovery, the results were excellent in 8 cases and good in 2 cases.
  
  
  CONCLUSIONS
  ETN has an angular stable locking system for intramedullary nails, which can enhance axial and transverse stability for the treatment of complex tibial fractures of type C. It will provide firm fixation and minimal invasion.
authors.affiliation: Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu Sichuan 610041, PR China.
authors.forename: Mingming
authors.initials: M
authors.lastname: Lei
authors.forename: Lei
authors.initials: L
authors.lastname: Liu
authors.forename: Tianfu
authors.initials: T
authors.lastname: Yang
authors.forename: Fuxing
authors.initials: F
authors.lastname: Pei
authors.forename: Chongqi
authors.initials: C
authors.lastname: Tu
authors.forename: Guanglin
authors.initials: G
authors.lastname: Wang
authors.forename: Yue
authors.initials: Y
authors.lastname: Fang
mesh_terms: D000328:Adult; D001858:Bone Nails; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation* / Q000379:methods; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D013978:Tibial Fractures / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult