title: Is intramedullary nailing applicable for distal tibial fractures with ankle joint extension?
abstract: OBJECTIVE
  This study aims to evaluate the functional and radiographic results and treatment complications of AO/OTA (Arbeitsgemeinschaft fur Osteosynthesefragen/Orthopaedic Trauma Association) type 43C1 and C2 fractures treated with intramedullary nailing.
  
  
  METHODS
  We retrospectively evaluated 35 AO/OTA type 43C1 and C2 patients (26 males, 9 females; mean age 39.8±16.9 years; range 19 to 82 years) treated with intramedullary nailing. Two interfragmentary screws out of nail were applied in 10 patients (29%), while one interfragmentary screw out of nail was applied in 17 patients (49%). Intramedullary nailing was applied in eight patients (23%) without external screws. Fracture union, union time, alignment problems, and complications were evaluated. Clinical evaluation of patients was conducted using the Olerud and Molander score and by measuring the ankle joint range of motion.
  
  
  RESULTS
  Union was achieved in all 35 patients. Mean union time was 16.5±2.8 weeks (range 12 to 24 weeks) and mean Olerud and Molander score was 88±8.24. Varus deformity was detected in one patient, valgus deformity was detected in two patients, and rotation deformity was detected in one patient. Superficial infection was detected in three patients (9%). Deep infection was not detected in any patient.
  
  
  CONCLUSIONS
  Intramedullary nailing is not contraindicated for simple intra-articular distal tibial fractures. In these fractures, intramedullary nailing performed in accordance with its technique, with an additional percutaneous screw if necessary, is a successful treatment option with high fracture union rates, high functional results, and low complication rates.
authors.affiliation: Department of Orthopedics and Traumatology, Bağcılar Training and Research Hospital, 34200 Bağcılar, İstanbul, Turkey. beytemur@yahoo.com.
authors.forename: Ozan
authors.initials: O
authors.lastname: Beytemür
authors.forename: Cem
authors.initials: C
authors.lastname: Albay
authors.forename: Oktay
authors.initials: O
authors.lastname: Adanır
authors.forename: Serdar
authors.initials: S
authors.lastname: Yüksel
authors.forename: Mehmet Akif
authors.initials: MA
authors.lastname: Güleç
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016512:Ankle Injuries / Q000503:physiopathology / Q000601:surgery*; D000843:Ankle Joint / Q000503:physiopathology / Q000601:surgery*; D017760:Bone Malalignment / Q000175:diagnosis / Q000503:physiopathology; D001863:Bone Screws; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000503:physiopathology; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult