Minimizing the complications of intramedullary nailing for distal third tibial shaft and metaphyseal fractures

BackgroundThe complications of intramedullary nailing of distal third tibial shaft and metaphyseal fractures have a direct impact on ankle and hind foot function.MethodsWe retrospectively evaluated 28 patients. Unreamed nail was negotiated across the well reduced fracture till subchondral bone and fixed with 2 to 3 distal locking screws in different planes.ResultsFracture union rate was 85%. Three out of 28 patients had malalignment. Mean ankle, hindfoot functional score was 85.ConclusionComplications can be minimized by impacting the unreamed nail till the subchondral bone while maintaining the fracture well reduced and by using multiple distal locking screws in different planes.