Biomechanical Test And Clinical Application Of The Improved Interlocking Itramedullary Nail For The Distal Tibial Fractures

Objective: The treatment of the â…¤and â…¥area tibial fracture is the debating focus in clinical study.The object was to evaluate the possibility and clinical value of the improved interlocking itramedullary nail for the The treatment of the â…¤and â…¥area tibial fractures. Methods: (1) Experiment: 6 tibial specimens picked out the flexible tissue and the other disease were divided into two groups at random, each of which was made into the same standard fracture models in â…¤and â…¥area tibia and was internally fixed by the improved interlocking nail and the dissecting plate separately. Axial compression test, three-point bend test and twist test were made and the results were got and analyzed. (2) Clinical material: 22 patients were treated â…¤and â…¥area tibial fracture in our hospital from September, 2002 to December, 2004. Sixteen of them were male and the other six were female. The average age was 38.5. Fifteen cases were â…¤area tibia fracture and seven were â…¥area. Fifteen cases were closed and seven were opened. All of them were fresh fracture . We treated these patients with the improved interlocking nail. Result: (1) Experimental results: It indicated that the interlocking itramedullary nail was superior to the steel plate after the axial compression test, three-point bend test and anti-twist test, but the anti-bend ability of the interlocking nail still need to be stronger. (2) Outcomes: Based on the Johner-Wruhs criteria, excellent, fine, and good results were achieved in 11 cases, 9 and 2 patients respectively. The excellent rate was 90.9%. The average total-load time was 13.5 weeks and the radioactive rays union time was 13 weeks. Two tibias were delayed union. Three of them were partial infection and one nail wasn't locked into the hole. Conclusion: The improved interlocking itramedullary nail is more advanced than the steel plate in biomechanics and is especially for the treatment of the tibia fracture (â…¤and â…¥area). From the clinical results, we can see that the improved interlocking nail is characterized of little disturbance to the partial flexible tissue, firm fixation, few complications, simple operation and speedy recovery, but one should strictly choose the correct surgical indication and the proper surgical opportunity to prevent the wound from opening again or the flexible tissue from infection.