O2433 MALUNITED FRACTURES OF TIBIA TREATED WITH INTERLOCKING INTRAMEDULLARY NAIL

Aim: This paper presents the treatment of malunited fractures of tibia with intramedullary interlocking nail with correction of malunion, in order to prevent gait abnormalities and pathological loading of the adjacent joints. Method: We treated sixteen fractures of tibia that were treated initially with P.O.P. or external þxation and led to malunion or considered leading to malunion. In most patients there was combination of deformities with severe gait abnormality. In case of solid malunion the deformity was corrected after open osteotomy at the fracture site. In case of non solid malunion the deformity was corrected closed or semi-closed. Stabilization was achieved with interlocking intramedullary nailing. Fibular osteotomy was performed when needed. All patients were mobilized early. Results: All fractures healed without deformity and patients returned to their previous activities. Conclusion: Although intramedullary interlocking nailing is the treatment of choice for fractures of long bones its indication can be extended to malunited fractures. This method maintains stable correction of the deformity until union and allows early mobilization of the patient. It is easier to correct rotational or angular deformities than shortening.