Intramedullary Nailing and Adjunct Permanent Plate Fixation in Complex Tibia Fractures.

The use of adjunct plate fixation is known to be a useful reduction aid during intramedullary nailing of the proximal tibia. We have expanded the indications beyond aiding the reduction and now use these plates as an adjunct to intramedullary nailing during the healing period. Specific indications include diaphyseal tibial fractures with severe bone loss/comminution and segmental tibial fractures with or without intraarticular extension. We believe the adjunctive permanent plate fixation technique may offer a treatment solution in these selected situations with the added benefit of immediate weight bearing.