The application of intramedullary nails and transmedullary support screws in surgical treatment of distal tibia fracture

Introduction. Fractures of the distal tibia are a difficult treatment problem due to specific anatomy this area and soft tissue injuries resulting from trauma. A fracture is short, has wide marrow cavity, asymmetric muscle forces acting on it can cause secondary displacements despite originally correct positioning. Against background problems presented above, fixation with an intramedullary nail (IMN) use TMS (trans medullary support) screws directional seems be best alternative for treatment. Aim. The aim study was evaluate bone repositioning after surgical fracture, time healing function upper ankle joint. Materials methods. Forty patients treated surgically were included in study. mean follow-up 25.3 months. joint injured limb evaluated using AOFAS, VAS SF-36 questionnaires. Radiological documentation assessed terms fragment repositioning, placement union fibula. Post-operative X-rays as well taken at end AP lateral projection also assessed, evaluating LDTA (lateral tibial angle) ADTA (anterior angle). Results. IMN + method follows: AOFAS score 91.5, 2.2 / 10 points. range motion joint: angles movement significantly greater case uninjured compared one. Bone obtained all patients. In 80% patients, achieved less than 6 Assessment surgery – angle 89 86 (standard 90, 85). Conclusions. according scale very good allowed anatomical fixation. shorter month most cases.