title: Distal Tibial Fractures: Intramedullary Nailing.
abstract: The tibia is an exposed bone with vulnerable soft tissue coverage and is therefore predisposed to local soft tissue problems and delayed bone healing. The objective in distal tibial fracture treatment is to achieve stable fixation patterns with a minimum of soft-tissue affection. Thus, the risk of soft tissue breakdown and bone healing complications is more likely related to open reduction and plating. Percutaneous, minimally invasive intramedullary nailing is a proven fixation mode for fracture stabilization in tibial shaft fractures. Anticipating the pitfalls, intramedullary nailing meets the requirements of the method of choice in distal tibial fracture fixation. In conclusion, intramedullary nailing of distal tibial fractures is a reliable method of fixation, possessing the advantages of closed reduction and symmetric fracture stabilization of an area with a delicate soft tissue situation, but prospective randomized trials are needed to compare modern intramedullary fracture fixation with modern plate fixation in distal tibial fractures.
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany. aruecker@uke.uni-hamburg.de.|Department of Trauma, Hand, and Reconstructive Surgery, University Hospital Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany. aruecker@uke.uni-hamburg.de.
authors.forename: Andreas H
authors.initials: AH
authors.lastname: Ruecker
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Hoffmann
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Martin E
authors.initials: ME
authors.lastname: Rupprecht
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Johannes M
authors.initials: JM
authors.lastname: Rueger
keywords: Concepts; Intramedullary nailing; Locking plate; Tibia fractures; Treatment
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