Closed nailing of tibial shaft fractures

Gad, Hossam; Kheir, I.H.Abul; Booz, M. K.

doi:10.1016/0020-1383(90)90005-f

Cited by 6 publications

(2 citation statements)

References 9 publications

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“…Several studies involving flexible intramedullary nailing of the tibia in adults are documented. [16][17][18] Wiss et al 16 reported that 48 of 52 fractures of the tibia healed at a mean of 17 weeks. Three patients developed angular malformation > 7˚ and five had shortening > 1.2 cm, but no func- We have reviewed 56 fractures of the tibia in 54 children, fixed with flexible intramedullary nails.…”

Section: Discussionmentioning

confidence: 99%

Flexible intramedullary nails for unstable fractures of the tibia in children

Vallamshetla

Silva

Bache

et al. 2006

The Journal of Bone and Joint Surgery. British volume

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Flexible intramedullary nailing is gaining popularity as an effective method of treating long-bone fractures in children. We retrospectively reviewed the records and radiographs of 56 unstable fractures of the tibia in 54 children treated between March 1997 and May 2005. All were followed up for at least two months after the removal of the nails. Of the 56 tibial fractures, 13 were open. There were no nonunions. The mean time to clinical and radiological union was ten weeks. Complications included residual angulation of the tibia, leg-length discrepancy, deep infection and failures of fixation. All achieved an excellent functional outcome. We conclude that flexible intramedullary fixation is an easy and effective method of management of both open and closed unstable fractures of the tibia in children.

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Section: Discussionmentioning

confidence: 99%

Flexible intramedullary nails for unstable fractures of the tibia in children

Vallamshetla

Silva

Bache

et al. 2006

The Journal of Bone and Joint Surgery. British volume

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“…Secondly, inaccurate nailing may result in malalignment. However, satisfactory alignment control has been repeatedly reported [2,6,7]. Thirdly, the incidence of non-union after reamed intramedullary nailing is 0-2% [1,2], whereas it is 6% after conservative treatment [1].…”

Section: Discussionmentioning

confidence: 99%

Which displaced spiral tibial shaft fractures can be managed conservatively?

Toivanen

Kyrö

Heiskanen

et al. 2000

International Orthopaedics

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The aim of the present study was to establish a threshold for the initial displacement of a spiral tibial shaft fracture beyond which its retention in an acceptable position cannot be guaranteed by plaster immobilization. We reviewed the records and radiographs of 131 plaster cast-treated patients with spiral tibial shaft fracture, initially displaced 50% or less, for patients whose fracture had either lost its acceptable retention or consolidated in an unacceptable position. The fractures were classified, according to the true initial displacement as measured on the first radiographs, into four pairs of categories using cut-off points of 10, 20, 30 and 40% of the diameter of the tibial diaphysis. Comparison was then made of the proportions of failed treatments between each of these pairs. Plaster cast treatments failed in 28% when the true initial displacement was 30% or less, and in 46% when the true initial displacement was more than 30%. The risk of failed plaster cast treatment increased when true initial displacement exceeded 30%. In all patients whose plaster cast treatment was interrupted the true initial displacement was more than 30%. We therefore conclude that diaphyseal fractures of the tibia for which the initial displacement exceeds 30% are not suitable for plaster cast treatment.Résumé L'objectif de cette étude était de déterminer le seuil de déplacement initial des fractures spiroïde du tibia après lequel la position acceptable ne peut être garantie sous immobilisation plâtrée. Nous avons revu les dossiers et les radiographies de 131 patients plâtrés présen-tant une fracture spiroïde du tibia avec un déplacement initial de 50% ou moins, pour découvrir les patients dont les fractures, soit ont perdu une réduction acceptable, soit se sont consolidées dans une position non-acceptable. Les fractures ont été classées selon le déplacement initial réel, mesurées sur les radiographies d'entrée. Quatre paires de catégories ont été crées en utilisant comme points de mesure, à savoir: 10, 20, 30 et 40% du diamè-tre de la diaphyse du tibia. Puis les proportions des traitements non réussies entre chacune des ces paires étaient comparées. Les traitements sous plâtre ont abouti à l´échec dans 28% des cas quand le déplacement initial réel était de 30% ou moins, et dans 46% des cas quand le déplacement initial réel était plus que 30%. Le risque de l'échec de traitement par plâtre n'a augmenté que légère-ment quand le déplacement initial a dépassé les30%. Le degré de déplacement initial réel des fractures dont les traitements plâtrés ont été interrompus était de plus de 30%. Ainsi nous aboutissons à la conclusion que les fractures de la diaphyse tibiale dont le déplacement initial dépasse 30% ne conviennent pas pour le traitement par immobilisation plâtrée.

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