The effect of intact fibula on functional outcome of reamed intramedullary interlocking nail in open and closed isolated tibial shaft fractures: A prospective study

Balaji, S Muthukumar; Chandra, Pavani; Devadoss, Sathish; Devadoss, A. Victor

doi:10.4103/0019-5413.177584

Cited by 6 publications

(5 citation statements)

References 15 publications

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“…Unlike other studies, in our study, open fractures were also included. Balaji et al reported that open tibial diaphysis fractures with an intact fibula had a longer healing time [15]. We did not find any difference in healing times in our study.…”

Section: Discussioncontrasting

confidence: 74%

Does fibula fracture have an impact on tibial healing?

Karslı,

Tekin,

Öğümsöğütlü

et al. 2021

Ann Clin Anal Med

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Aim: Tibial diaphysis fractures are frequently-encountered fractures of the lower extremities. Fibula fracture may accompany these fractures. In this study, we investigated the effects of accompanying fibula fracture on the healing of tibial diaphysis fractures, which were treated by intramedullary nail fixation. Materials and Methods: Data of the patients who presented to our clinic and underwent intramedullary nailing for tibial diaphysis fractures between January 2016 and December 2018 were reviewed. Patients were divided into two groups based on the presence (Group 1) or absence (Group 2) of accompanying fibula fracture. Database which included information such as fracture type (open or closed fracture), fracture healing time, angulation, and smoking history were retrospectively analyzed. The effect of accompanying fibula fracture and other parameters on the healing time following intramedullary nail fixation of tibia diaphysis fractures was investigated. The Shapiro-Wilk, the Mann-Whitney U, and the Chi-Square tests were used for statistical analysis. Results: One hundred twenty-eight patients were included in this study. Among these patients, 101 had accompanying fibula fracture while 27 had intact fibula. Fracture healing times were significantly shorter in the latter group (p=0.001). However, there was no statistically significant difference between the groups in terms of fracture angulation except for valgus angulation. Smoking history and the presence of open or closed fracture did not have a significant impact on outcomes (p=0.249). Discussion: Intact fibula shortens the healing time after intramedullary nail fixation of tibia diaphysis fracture.

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Section: Discussioncontrasting

confidence: 74%

Does fibula fracture have an impact on tibial healing?

Karslı,

Tekin,

Öğümsöğütlü

et al. 2021

Ann Clin Anal Med

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“…12 Balaji et al found the time to union to be mean 19.7 weeks in 56 cases of isolated tibial fracture with an intact fibula. 13 In the current study, the meantime to union was determined as 22.23 weeks in Group IF and 19.09 weeks in Group FF (p< 0.001). The intact fibula was observed to have prolonged the time to union.…”

Section: Discussionmentioning

confidence: 82%

Role of fibula in healing of closed diaphyseal tibial fractures treated with intramedullary interlocking nail

Rajan¹,

Borgohain²,

Sonowal³

et al. 2022

IJOS

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Isolated tibial shaft fractures with intact fibula are a fairly common injury. Hospital records often fail to mention the intact fibula in such injuries. Many studies blame that with an intact fibula, tibiofibular length discrepancy develops resulting complications associated with the management of tibia fractures like delayed union, non-union, and malunion. A prospective study in 59 patients of tibial shaft fractures with 33 having fibula fracture (FF) and 26 patients with an intact fibula(IF) were treated by closed intramedullary interlocking nail between June 2019 to July 2020. Radiological follow up were at 6 weeks, 3 months, 6 months. The final functional evaluation was done with Johner and Wruh’s criteria at the end of 6 months.The mean duration of surgery in group IF was 106.62 minutes wherein group FF was 97.91 minutes The radiological union was early with a mean union rate of 19.09 weeks in group FF compared to group IF where the mean was 22.23 weeks. The percentage of nonunion was 3.85% in group IF. 4 patients had a deformity where the level of tibia fracture was lower 1/3 diaphyseal with fibula fracture at the same level. At the final follow up the functional score had no significance. The union of a tibial shaft fracture was slower in patients with an intact fibula compared to those with a fractured fibula. Although the intact fibula was more proven for the delayed union, non-union, it prevents malalignment.

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“…In a study by Court Brown et al [6], 14 isolated tibial fractures were compared with cases of both bone fractures and a significant difference was determined in the time to union (16.7 weeks vs.15.6 weeks). Balaji et al [15] found the time to union to be mean 19.7 weeks in 56 cases of isolated tibial fracture with intact fibula. In the current study, the mean time to union was…”

Section: Discussionmentioning

confidence: 99%

Effect of anatomic fibula on tibia union and alignment after intramedullary nailing of tibia shaft fractures

Evren¹,

Yaradılmış²,

Okkaoğlu³

et al. 2020

The European Research Journal

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Objectives: The effect of an intact or fixated fibula on tibial union and alignment in tibial shaft fractures applied with intramedullary nailing is investigated. Methods: A retrospective examination was made of 67 patients aged 19-85 years who were applied with intramedullary nailing for a tibial shaft fracture (AO-42) between January 2010 and December 2016. The 44 patients included in the study were separated into 2 groups as those with anatomic fibula (Group 1, n = 12) and those with a fibula fracture which is not fixated (Group 2, n = 32). The patients were evaluated in respect of bone union and malalignment from direct radiographs. Union was evaluated according to the RUST criteria, and the threshold for malalignment was taken as 5˚ in the coronal and sagittal planes. Results: The patients comprised 24 males and 20 females (M/F: 6/5) with a mean age of 42.7 years (range, 19-76 years). Non-union was observed in 3/12 patients (25%) in Group 1, and in 2/32 (6.3%) patients in Group 2 at 6 months. Malalignment was observed in 1/12 (8.3%) patients in Group 1 (procurvatum) and in 7/32 (21.8%) patients in Group 2, of which 3 (9.3%) were varus, and 4 (12.5%) were valgus. The rate of malalignment was significantly lower in Group 1 than in Group 2. Conclusions: The results demonstrated that bone union of a tibial shaft fracture is slower in patients with an anatomic fibula compared to those with non-anatomic fibula. Although the anatomic fibula slows the rate of union, it prevents malalignment.

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The effect of intact fibula on functional outcome of reamed intramedullary interlocking nail in open and closed isolated tibial shaft fractures: A prospective study

Cited by 6 publications

References 15 publications

Does fibula fracture have an impact on tibial healing?

Does fibula fracture have an impact on tibial healing?

Role of fibula in healing of closed diaphyseal tibial fractures treated with intramedullary interlocking nail

Effect of anatomic fibula on tibia union and alignment after intramedullary nailing of tibia shaft fractures

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