Distal third tibia fractures treated with interlocking intramedullary nail

The management of extraarticular fracture of the distal tibia remains controversial. Surgeons are not very keen on using intramedullary interlocking nail for these fractures because of diffi cult nail fi xation, wider medullary canal in the distal tibia and late angulation .The advent of newer nails with locking holes in the distal parts has made nailing possible even in cases of distal tibia fractures. Between January 2012 to June 2014, 17 skeletally mature patients with mean age of 35.8 years with distal third tibia fractures within 11 cm from the tibial plafond were treated with intramedullary interlocking nail. The radiological and functional outcome was evaluated with a follow up of at least one year. All fractures united within the study period with a mean time of union 21.76 weeks. On the fi nal follow up, 4 patients had a mean angulation of 2.75 degrees in coronal plane, 6 patients had an angulation of 3.5 degrees (2-8 degrees) on the saggittal plane and no rotational malalignment. None of the patients developed angulation outside the acceptable range. The average Olerud and Molander score at fi nal follow up was 91.76 ranging from 85 to 100 with 12 (70.6%) of the patients having good outcome and 5(29.4%) of them having an excellent outcome. Intramedullary interlocking nailing with two distal locking bolts in case of distal third tibia fracture leads to good to excellent functional outcome and good rate of union.