[Flexible locked centromedullary osteosynthesis. Results of 125 cases of unstable cortical bone fractures of the tibia].

Abstract

We present a series of 125 cases of centromedullary fixation with a flexible locked nail of unstable cortical bone fractures of the tibia in which we studied healing conditions in order to identify parameters which would predict the rate of consolidation. One hundred ten fractures followed more than 6 months were included in the statistical analysis. For 94 fractures, primary consolidation was achieved in a mean 11 weeks. Fractures situated in the lower portion of the tibia healed the fastest (10 weeks). However, opening the fracture site and comminutive fractures did not affect the rate of healing except for proximal fractures and for fractures with a gap exceeding 10 cm. These two parameters, width of the bone gap (whether trauma induced or iatrogenic) and proximal localization of the fracture were the cause of the cases with long periods of non-consolidation (14.5%). The speed of peripheral osteogenesis is considered to be accelerated with the flexible nail as seen in our 94 cases where no conversion was necessary. This method provides a mean 1 month gain over consolidation times compared with locked nailing where the distal locking probably increases the rigidity of the system.