Table of Contents
ISRN Orthopedics
Volume 2014, Article ID 542623, 7 pages
Clinical Study

Distal Tibial Metaphyseal Fractures: Does Blocking Screw Extend the Indication of Intramedullary Nailing?

1Coimbatore Medical College, Coimbaore 641018, India
2Madras Medical College, Chennai 600001, India
3Kilpauk Medical College, Chennai 600010, India

Received 12 November 2013; Accepted 12 December 2013; Published 17 February 2014

Academic Editors: A. Combalía and G. Matthes

Copyright © 2014 Mugundhan Moongilpatti Sengodan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Aim. To evaluate the clinical use of blocking screws as a supplement to stability in distal tibial metaphyseal fractures treated with statically locked intramedullary nail. Main Outcome Measurement. Alignment and reduction preoperatively, postoperatively, and at healing were the main outcome measured with an emphasis on maintenance of initial reduction on followup. Patients and Methods. This was a prospective study of 20 consecutive cases of distal tibial metaphyseal fractures treated with statically locked intramedullary nailing with supplementary blocking screw between August 2006 and September 2007 with a maximum followup of 3 years. Medullary canal diameter was measured at the levels of fracture and isthmus. Results. The mean diameter of tibia at the level of isthmus was 11.9 mm and at the fracture site was 22.9 mm. Mean length of distal fracture segment was 4.6 cm. Mean varus/valgus alignment was 10.3 degrees preoperatively and 1.7 degrees immediatly postoperatively and was maintained till union. Using Karlstrom-Olerud score the outcome was excellent to good in 90%. Conclusion. We conclude that the use of blocking screw as a supplement will aid in achieving and maintaining the reduction of distal tibial metaphyseal fractures when treated with intramedullary nailing thereby extending the indication of intramedullary nailing.