족관절 내과 골절으 동반한 경골 간부골절

Fractures of tibial shaft accompanied by ipsilateral medial malleolar fracture are rare. It is probably due to different mechanism of injury. Usually tibial shaft fractures are caused by direct force applied to the fracture site or violent rotational farce: exerted to some distant area. Medial malleolar fractures are caused by rotational or valgus, varus force exerted to the foot. Many modalities of the treatment can be employed in such cases, including conservative, operative, or mixed. By the way with any kind of treatment, if stable fixation can be achieved for both fractures, early mobilization and weight bearing can be permitted and more satisfactory outcome can be expected. Since August 1990, we experienced 4 cases of ipsilateral tibial shaft and medial malleolar fracture. All the cases were associated with automobile accident. Internal fixation using intramedullary nailing was performed for the tibial shaft fractures. And fixation using tension band wiring, threaded K-wires, malleolar screws was performed for the medial malleolar fractures, respectively. The results are as tollows; l. In 3 cases, the mechanism of injury was considered as direct valgus force to both the tibial shaft and medial malleolus because the foot was fixed. In the other case, different forces were thought to be responsible for each fractures. 2. In two cases, union of the tibial shaft fracture was achieved within postop. 4 months. In another case, complete union was achieved at 15 months from the injury after augumentation bone graft. In the other case, augumentation bone graft was performed at postop. 4 months, and union was achieved at post trauma 8 months. 3. In all cases, the medial malleolar fractures united in 8 weeks postoperatively.