title: [Assisting plate with reamed intramedullary nailing for segmental fractures of proximal-middle tibia].
abstract: OBJECTIVE
  To evaluate the efficacy and safety of combining reduction plating with reamed intramedullary nailing for segmental fractures of proximal-middle tibia.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Orthopaedics, Shanghai First People's Hospital, Shanghai 200080, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Lin
authors.forename: Qiu-Gen
authors.initials: QG
authors.lastname: Wang
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Huang
authors.forename: Jian-Dong
authors.initials: JD
authors.lastname: Wang
authors.forename: Fan
authors.initials: F
authors.lastname: Li
authors.forename: Wei
authors.initials: W
authors.lastname: Gao
authors.forename: Hao-Qing
authors.initials: HQ
authors.lastname: Li
authors.forename: Jie
authors.initials: J
authors.lastname: Tao
mesh_terms: D000328:Adult; D000368:Aged; D001858:Bone Nails; D001860:Bone Plates; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D017102:Fracture Healing; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult