Fatigue Failure in Small Diameter Tibial Nails

Whittle, A. Paige; Wester, W.; Russell, Thomas A.

doi:10.1097/00003086-199506000-00013

Cited by 50 publications

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“…The number of pseudoarthroses may indicate low stability at the fracture site. The rate of metal failure has been higher than in previous series [8,14,15,17,30,31]. This could be explained since, as we were encouraged by the initial results and by our experience with reamed nails, we encouraged early weightbearing which is not recommended with this type of osteosynthesis.…”

Section: Discussionmentioning

confidence: 87%

Unreamed intramedullary locking nailing for open tibial fractures

García-López

Marco

López-Durán

1998

International Orthopaedics

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Section: Discussionmentioning

confidence: 87%

Unreamed intramedullary locking nailing for open tibial fractures

García-López

Marco

López-Durán

1998

International Orthopaedics

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“…Mosheiff et al reported that 22 of 52 patients with distal tibial metaphyseal fractures treated with unreamed nailing required secondary procedures (e.g. dynamisation, autogenous bone grafting, fibulectomy) to progress to union [32].…”

Section: Resultsmentioning

confidence: 99%

Results of Dynamic Interlock Nailing in Distal Tibial Fractures

Gadegone¹,

Salphale²,

Lokhande³

2015

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A study was performed in adults to determine the efficacy of closed reduction and intramedullary nailing in dynamic mode on union, implant failure and incidence of malalignment in patients who sustained an extra-articular fracture of the distal tibia. Methods: Between January 2007 and December 2013, one hundred and twelve patients of distal tibia that involved the distal 6 cm of the tibia were treated at our hospital with reamed intramedullary nailing with use of two distal interlocking screws and one proximal screw in dynamic mode. The augmentation was done with poller screws whenever it was necessary. The nailing of fibular fractures was done in 27 cases. There were 85 males and 27 females with a mean age of 30.9 (range: 20 to 72). Eighty fractures were closed whereas 32 were grade 1 open fractures. Results: The average time to union of the closed fracture was 15.4 weeks (range: 12 -28 weeks). The healing times for the primarily nailed compound Grade I averaged 17.8 (range: 15 -34 weeks). After minimum follow-up of one year, rate of primary union was in 97.32%. One case of broken nail required revision surgery. There were three cases of delayed union and two cases of non union. In one case there was deep infection which required exchange nailing with antibiotic impregnated nail. There was breakage of interlocking screws in three cases but fracture had united. In twenty two cases acceptable malalignment of the tibia was observed after union. The outcome was determined at a minimum of one year in our study based on the criteria of Johner and Wruhs. Out of 112 patients, 79 patients had excellent results, 29 had good results and 4 had fair results. Conclusions: The dynamic osteosynthesis of distal tibia by interlocking nail and judicious use of poller screws is an effective alternative for the treatment of distal metaphyseal tibial fractures.

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“…The small size of unreamed tibial nail is associated with increased rate of nail or screws breakage. 7,8 Reaming of the medullary canal may lead to vascular damage and thermal necrosis of the tibia. 9 The recent use of locked intramedullary nail has shown promising results.…”

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confidence: 99%

Functional Outcome of Interlocking Nailing of Type I and Ii Compound Fracture Tibia

Baby¹,

Kunjappan²

2018

jemds

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BACKGROUND Introduction of closed locked intramedullary nailing has revolutionised the management of fractures of femur and tibia. The study is to prove type-I and type-II open fractures with comparatively less soft tissue damage and contamination, can be safely managed by debridement, early wound care and an unreamed/ reamed interlocking nailing without any deep infection hence allowing early mobilisation, reducing morbidity, reducing reoperation/ secondary procedures and malunion/ non-union. MATERIALS AND METHODSA prospective observational study was approved by the Hospital Ethical Committee and an informed consent was taken from all patients. 30 patients who underwent IL nailing from March 2011 to 2012 were enrolled in this study. Of the 30 patients, 17(56.7%) patients had fracture in right tibia and 13(43.3%) had fracture in left tibia. Age of the patients ranged from 18 to 65 years with mean age being 35.5. Males dominated (73.3%) in this study population and the sex ratio was found to be 2.75. Females were represented by only 26.7%. RESULTSIn this study all the cases united irrespective of the Gustilo and Anderson (G and A), OTA classification, Level of fracture and Mode of injury. Time of union ranges between 15 to 24 weeks with mean time of union is 20.1. Shortest time for a union was within 15 weeks (1 case) which was grade I Gustilo and Anderson, middle 3 rd , transverse, OTA-A fracture and maximum time taken was a period of 24 weeks (2 cases) which were type II, lower3 rd fractures. From this, it is observed that there is a difference in union rate between Level, Gustilo and Anderson, and OTA classifications. In this study, it is observed that there were no cases of deep infection. CONCLUSIONClosed interlocking intramedullary nailing is an effective method of treatment for Gustilo and Anderson type I and II compound tibial diaphyseal fractures. It is based on the principle of promoting biological healing and allows gradual weight bearing. Closed nailing and static locking is a technically demanding procedure. Risk of exposure to radiation is there. This method offers the possibility of maintenance of length, alignment and rotational stability in fractures of the tibial shaft, while preserving the biological environment of fracture healing. The fixation is rigid, hence there is no need for external immobilisation prior to callus formation and weight bearing. KEYWORDSCompound Fracture Tibia, Gustilo and Anderson (G and A) Classification, Interlocking Intramedullary Nailing. HOW TO CITE THIS ARTICLE: Baby S, Kunjappan MM. Functional outcome of interlocking nailing of type I and II compound fracture tibia.

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Fatigue Failure in Small Diameter Tibial Nails

Cited by 50 publications

References 0 publications

Unreamed intramedullary locking nailing for open tibial fractures

Unreamed intramedullary locking nailing for open tibial fractures

Results of Dynamic Interlock Nailing in Distal Tibial Fractures

Functional Outcome of Interlocking Nailing of Type I and Ii Compound Fracture Tibia

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