DISTAL METAPHYSEAL FRACTURES OF THE TIBIA WITH MINIMAL INVOLVEMENT OFTHE ANKLE

We reviewed 63 patients with fractures of the distal tibial metaphysis , with or without minimally displaced extension into the ankle joint. The fractures had been caused by two distinct mechanisms, either a dir ect bending force or a twisting injury. This influenced the pattern of the fracture and its time to union. All fractures were managed by sta tically locked intramedullary nailing, with some modifications of the procedure used for diaphyseal fractures. There were few intra-operativ e complications, At a mean of 46 months, all but five patients had a s atisfactory functional outcome. The poor outcomes were associated with either technical error or the presence of other injuries. We conclude that closed intramedullary nailing is a safe and effective method of managing these fractures.