Intramedullary tibial nailing in distal third tibial fractures: distal locking screws and fracture non-union

Abstract

Distal third tibial fractures are prone to non-union following tibial nail insertion. The purpose of this study was to assess the union of distal third tibial fractures in patients who have undergone intra-medullary (IM) tibial nailing with one versus two distal locking screws. Sixty-five patients who had intramedullary tibial nail fixation were retrospectively analysed. Our results showed that 80% of non-unions in distal third fractures had only one distal locking screw compared to 20% who had two distal locking screws. This is statistically significant (p<0.01). We therefore conclude that two distal locking screws are essential for distal third fractures.

Interlocking nailing in fractures of distal tibia

“…Mohammed et al studied relation of nonunion and distal interlocking and showed that there was a high incidence of non-union in distal third tibia fractures treated with IM nailing when only one distal locking screw was used. 6 Therefore, they recommend two distal locking screws in IM nail fixation of distal third tibia fractures. If two distal locking screw insertions are not possible due to the distal nature of the fracture, they recommend an alternate form of fixation.…”

Fatigue performance of angle-stable tibial nail interlocking screws

“…With upcoming implant technology, indication for intramedullary tibial nailing has extended towards extraarticular fractures of the distal third of the bone [5,6]. This change is accompanied by adverse effects like high rates of delayed bone healing, nonunion or malalignment and an incidence of distal locking screw failure ranging from 6 % to 14 % [1,3,7,8].…”

The primary stability of angle-stable versus conventional locked intramedullary nails

“…There is one area of agreement among trauma surgeons: these fractures need to be treated operatively [1][2][3][4]. The standard treatment option includes open reduction and internal fixation using angular stable plate osteosynthesis.…”