Treatment of distal metaphyseal fractures of the tibia with the interlocking flexible osteosynthesis system

Purpose Accurate anatomic identification of distal metaphyseal fractures of the tibia is necessary when comparing the fixation ability of internal fix ation devices. First, we have set the dimensions of the metaphyseal area. T he purpose of this study was to evaluate the Interlocking Flexible Osteosyn thesis system in properly selected distal metaphyseal fractures, not to be confused with distal shaft fractures. Patients This study involves 28 fractures, including 10 diaphyseal-metaphys eal fractures, and 18 pure metaphyseal fractures, 9 of which were distal fr actures involving the inferior half of the metaphysis. Five of them were se gmental fractures. Results There were 5 severe complications: early loosening (1), nonunions ( 2), severe malalignments in 2. These resulted from a combination of insuffi cient distance between the tips of pins, with severe demineralization of bo ne tissue. The authors have emphazied the technical means available to avoi d this. Twenty-five fractures united at a mean of 13.5 +/- 5 weeks (all typ es). Conclusion Such a fixation is reliable as long as certain technical rules a re respected, which requires a great deal of experience with the method.