J Korean Orthop Assoc.  2017 Jun;52(3):240-248. 10.4055/jkoa.2017.52.3.240.

The Usefulness of Blocking Screw in Intramedullary Nail of Distal Tibial Metaphyseal Fracture

Affiliations
  • 1Department of Orthopedic Surgery, School of Medicine, Chosun University, Gwangju, Korea. leejy88@chosun.ac.kr

Abstract

PURPOSE
To evaluate the usefulness of blocking screws in distal tibial metaphyseal fractures treated with intramedullary nailing.
MATERIALS AND METHODS
A total of 18 patients with distal tibial metaphyseal fractures, who underwent intramedullary nailing treatment with blocking screws between January 2012 and December 2014 and had a minimum follow-up of 1 year, were retrospectively reviewed for analysis. There were 7 patients with open fracture and 4 patients with intra-articular fracture. The location of the blocking screws was previously determined according to the fracture pattern. Moreover, the preoperative and postoperative angular alignment was measured. Patients received regular postoperative radiographic check-up, and the time-to-bone union and the incidence of nonunion were recorded. The clinical outcome was evaluated using the modified functional Kalstrom-Olerud score.
RESULTS
All fractures healed completely without nonunion at an average of 17.7 weeks. The mean coronal/sagittal alignment improved from 6.4/4.8 degrees preoperatively to 2.5/1.9 degrees postoperatively. The alignment was maintained until complete union. There were 3 cases of anterior knee pain but no complications related to the blocking screw and wound infection. Using a modified functional Karlstrom-Olerud score, the outcome was considered good to excellent in 83.4% of the patient cohort.
CONCLUSION
We conclude that the blocking screws may help the maintenance of reduction and alignment in distal tibial metaphyseal fractures treated with intramedullary nailing.

Keyword

blocking screw; distal tibial metaphyseal fracture; intramedullary nail
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