• OBJECTIVE
    • To evaluate the efficacy of intramedullary nailing in diaphyseal tibia fractures with distal intraarticular involvement.
  • DESIGN
    • Retrospective.
  • SETTING
    • Henry Ford Hospital, a level I trauma center.
  • PATIENTS/PARTICIPANTS
    • Twenty patients with twenty fractures at an average of twenty-two months of follow-up were evaluated. There were fifteen closed and five open fractures.
  • INTERVENTION
    • All fractures were stabilized with lag screw fixation (with or without supplemental plates) of the intraarticular-fracture extension or ankle fracture, and intramedullary nailing of the diaphyseal tibia fracture.
  • MAIN OUTCOME MEASUREMENTS
    • Time to bony union, malunion, knee and ankle range of motion, early arthrosis, and any complications of treatment were assessed.
  • RESULTS
    • Nineteen fractures healed, with an average time to bony union of seventeen weeks. One nonunion after a grade IIIB open fracture required exchange nailing and healed after sixty-two weeks. Nineteen fractures had excellent alignment after healing. There were no infections.
  • CONCLUSIONS
    • The indications for intramedullary nailing of unstable diaphyseal tibia fractures may be extended to include certain fractures with distal extension into the ankle joint, as well in a tibial shaft fracture occurring in combination with a noncontiguous ipsilateral ankle fracture.