Retrospective two-institution study evaluating reamed intramedullary nailing for tibial fractures within 5 cm of the ankle joint — a zone traditionally considered difficult or inappropriate for nailing. Asks whether this technique can reliably achieve and maintain alignment, achieve union, and deliver acceptable functional recovery, including in fractures with simple articular extension.
When you see a distal tibial fracture within 5 cm of the plafond, intramedullary nailing is a viable option — even with simple articular extension — provided you fix the articular component percutaneously first and use fibular plating or a percutaneous clamp to control alignment before passing the nail.
Warn patients with open fractures that functional outcomes will be significantly worse, and counsel all patients that meaningful recovery continues well past the one-year mark.
Retrospective two-institution study evaluating reamed intramedullary nailing for tibial fractures within 5 cm of the ankle joint — a zone traditionally considered difficult or inappropriate for nailing. Asks whether this technique can reliably achieve and maintain alignment, achieve union, and deliver acceptable functional recovery, including in fractures with simple articular extension.
When you see a distal tibial fracture within 5 cm of the plafond, intramedullary nailing is a viable option — even with simple articular extension — provided you fix the articular component percutaneously first and use fibular plating or a percutaneous clamp to control alignment before passing the nail.
Warn patients with open fractures that functional outcomes will be significantly worse, and counsel all patients that meaningful recovery continues well past the one-year mark.