Displaced tibial shaft fractures: A prospective randomized study of closed intramedullary nailing versus cast treatment in 53 patients

Karladani, Abbas Hallaj; Granhed, Hans; Edshage, Björn; Jerre, Ragnar; Styf, Jorma

doi:10.1080/000164700317413139

Cited by 80 publications

(37 citation statements)

References 32 publications

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“…By using Johner and Wruhs classification [11] no significant difference was found between the study groups. This finding does not directly tally with those in previous studies in which intramedullary nailing proved superior compared with closed non-operative treatment [1,3,9,12]. However, it should be noted that our material consisted purely of low-energy fractures while other studies have also included high-energy trauma cases [1,3,9,12].…”

Section: Discussioncontrasting

confidence: 52%

“…There is general agreement that the intramedullary locking nail (IMLN) is justified in the treatment of comminuted [17] and markedly displaced fractures [4,9,12]. However, our previous studies [20,21] were also in favor of intramedullary nailing in the treatment of lowenergy, closed or open grade I [8], simple or spiral wedge [17] fractures displaced less than 50% of the shaft diameter.…”

Section: Introductionmentioning

confidence: 93%

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Treatment of low-energy tibial shaft fractures: plaster cast compared with intramedullary nailing

Toivanen

Honkonen

Koivisto

et al. 2001

International Orthopaedics (SICOT)

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We analyzed data from 87 patients who had displaced closed or open grade I simple or spiral wedge tibial shaft fractures caused by low-energy impact. Fiftyfour patients were treated with plaster cast and 33 with intramedullary locking nail (IMLN). Delayed union only occurred in 8 patients after plaster cast treatment. Fortytwo patients in the IMLN group and one in the plaster cast group suffered from anterior knee pain. Final treatment outcome, healing time, hospitalization time and duration of sick leave were assessed on the basis of 25 matched pairs of patients. Mean healing time, hospitalization time and sick leave in the plaster cast and IMLN groups were 19 (SD 6.7) and 12 (SD 4.4) weeks (P<0.001); 8 (SD 4.8) and 7 (SD 2.7) days (P=0.686); and 195 (SD 81) and 106 (SD 31) days (P=0.001), respectively. No difference was found between plaster cast and IMLN groups when the outcome was evaluated using the criteria of Johner and Wruhs.

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Section: Discussioncontrasting

confidence: 52%

Section: Introductionmentioning

confidence: 93%

Treatment of low-energy tibial shaft fractures: plaster cast compared with intramedullary nailing

Toivanen

Honkonen

Koivisto

et al. 2001

International Orthopaedics (SICOT)

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“…For patients treated with intramedullary nailing and EFs, partial weight bearing in standing position is allowed after a few days. These benefits lead to better blood supply to the site of the bone and soft tissue wounds, allowing a faster healing process 15,23,24 .…”

Section: Discussionmentioning

confidence: 99%

A visão do ortopedista brasileiro sobre a descarga parcial de peso em ortostase nas fraturas expostas da diáfise da tíbia após osteossíntese

Sella¹,

Machado²,

Fernandes³

et al. 2009

Rev. bras. fisioter.

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There are studies comparing osteosynthesis devices and surgical aspects, but no references were found on how or when to allow weight bearing on the affected limb in the standing position. Objectives: The present study learned from Brazilian orthopedists which methods of osteosynthesis they use to treat open tibial fractures, whether they refer patients to physical therapy, when and why they allow partial weight bearing for both physical activity and therapy. Methods: Two hundred and thirty-five orthopedists answered a questionnaire during the 14 th Brazilian Conference of Orthopedic Trauma. Results: The results showed that, in Brazil, the most widely used osteosynthesis device is the external fixator, but earlier weight bearing while standing occurs when intramedullary nails are used.Most orthopedists refer patients to physical therapy and allow partial weight bearing in the standing position according to the material used for synthesis. Conclusions: It was concluded that there is a preference for external fixation, that most orthopedists refer patients to physical therapy and that the synthesis material influences restrictions on partial weight bearing.Key words: osteosynthesis; tibia; physical therapy; orthopedist. ResumoContextualização: As fraturas da diáfise da tíbia são as mais frequentes dentre as dos ossos longos. Há descrições na literatura, de acordo com o método e dispositivo de tratamento, com recomendações que vão desde a descarga total até a proibição do suporte de peso corporal em ortostase. Existem estudos comparando os dispositivos de osteossíntese e os diversos aspectos cirúrgicos, porém não são encontradas referências que descrevam como e quando se deve liberar a descarga sobre o membro acometido na posição ortostática. Objetivos: Verificar, entre os ortopedistas brasileiros, qual ou quais são os métodos de osteossíntese adotados para o tratamento de fraturas expostas de tíbia, se indicam o tratamento fisioterápico, quando e quais fatores influem para liberar a descarga parcial em ortostase, tanto para a função quanto para a fisioterapia.

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“…[1][2][3][4][5][6][7] However, up to 79% of patients need complementary procedures for certain complications. 8 Pain in the knee is a frequent complication in 22% to 71% of the cases, [9][10][11] and breaking of the screws in unreamed locked nails occurs in up to 52% of cases with early weight bearing.…”

Section: Introductionmentioning

confidence: 99%

“…7 The degree of mobility of the knee joint, of the ankle, and of the talocalcaneal joint (subtalar) was observed during a physical exam performed at the end of 1 year of follow-up and was expressed as a percentage in comparison to the normal side.…”

Section: Introductionmentioning

confidence: 99%

Comparative Study of the Locked Intramedullary Nail and Ender Pins in the Treatment of Tibial Diaphyseal Fractures

Sakaki

Crocci

Zumiotti

2007

Clinics

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MATERIALS AND METHODS:Forty-four patients with unilateral tibial diaphyseal fractures were treated with intramedullary nails or Ender pins. Twenty patients were treated with an unreamed intramedullary nail with access via the patellar tendon with static locking. Twenty-four patients were treated with Ender pins introduced medially and laterally with respect to the tuberosity of the tibia. The main parameters analyzed were type of reduction, complications, union rate, deformities, joint mobility, pain, gait, effort capacity, presence of neurovascular disorders, and complaints related to the synthesis material. RESULTS: During 1 year of follow-up, the fractures of 90.0% of the patients with intramedullary nails and 95.7% of patients with Ender pins healed within an average of 21.5 weeks and 20.9 weeks, respectively. The significant findings were as follows: patients treated with Ender pins had less mobility of the subtalar joint; patients treated with intramedullary nails were more likely to have pain in the knee; both groups showed shortening of the tibia at the end of 1 year of treatment. CONCLUSIONS:The two methods are similar in the treatment of type A, B, and C2 tibial diaphyseal fractures.

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Displaced tibial shaft fractures: A prospective randomized study of closed intramedullary nailing versus cast treatment in 53 patients

Cited by 80 publications

References 32 publications

Treatment of low-energy tibial shaft fractures: plaster cast compared with intramedullary nailing

Treatment of low-energy tibial shaft fractures: plaster cast compared with intramedullary nailing

A visão do ortopedista brasileiro sobre a descarga parcial de peso em ortostase nas fraturas expostas da diáfise da tíbia após osteossíntese

Comparative Study of the Locked Intramedullary Nail and Ender Pins in the Treatment of Tibial Diaphyseal Fractures

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