Treatment of distal tibial shaft fractures by three different surgical methods: a randomized, prospective study

Li, Yongchuan; Jiang, Xi; Guo, Qinghe; Zhu, Lei; Ye, Tianwen; Chen, Aimin

doi:10.1007/s00264-014-2294-1

Cited by 94 publications

(116 citation statements)

References 40 publications

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“…Both treatment methods have advantages and disadvantages. [5][6][7][8][9][10][11][12][13][14][15] One of the major findings of our study is the significantly higher rate of valgus malunion. This situation may be due to technical problems during the implementation of IMN, or due to the small number of fibular fixation in our study.…”

Section: Discussionmentioning

confidence: 89%

“…[10][11][12][13][14][15][16][17] Marcus et al [1] detected 1% superficial infection and 2% deep infection in 23 intra-articular extending tibia fractures treated with IMN. Katsenis et al [2] never encountered infection in 50 patients treated with IMN.…”

Section: Discussionmentioning

confidence: 99%

“…[3,8] Although the fixing method with plate has the advantage of providing better mechanical support, there are publications reporting more complaints with this method, such as soft tissue problems and implant irritation. [9][10][11][12] In the intramedullary nailing method, although soft tissue problems and complaints such as irritation connected to the implant are less frequent, mechanical problems and symptoms such as anterior knee pain are reported more frequently. [10,13] But there are also some literature information which states that intramedullary fixation is stiffer.…”

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confidence: 99%

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Is intramedullary nailing applicable for distal tibial fractures with ankle joint extension?

Beytemür¹

2016

Eklem Hastalik Cerrahisi

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ÖZ Amaç : We retrospectively evaluated 35 AO/OTA type 43C1 and C2 patients (26 males, 9 females; mean age 39.8±16.9 years; range 19 to 82 years) treated with intramedullary nailing. Two interfragmentary screws out of nail were applied in 10 patients (29%), while one interfragmentary screw out of nail was applied in 17 patients (49%). Intramedullary nailing was applied in eight patients (23%) without external screws. Fracture union, union time, alignment problems, and complications were evaluated. Clinical evaluation of patients was conducted using the Olerud and Molander score and by measuring the ankle joint range of motion. Results: Union was achieved in all 35 patients. Mean union time was 16.5±2.8 weeks (range 12 to 24 weeks) and mean Olerud and Molander score was 88±8.24. Varus deformity was detected in one patient, valgus deformity was detected in two patients, and rotation deformity was detected in one patient. Superficial infection was detected in three patients (9%). Deep infection was not detected in any patient. Conclusion: Intramedullary nailing is not contraindicated for simple intra-articular distal tibial fractures. In these fractures, intramedullary nailing performed in accordance with its technique, with an additional percutaneous screw if necessary, is a successful treatment option with high fracture union rates, high functional results, and low complication rates.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Is intramedullary nailing applicable for distal tibial fractures with ankle joint extension?

Beytemür¹

2016

Eklem Hastalik Cerrahisi

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“…It is possible to achieve anatomical alignment in open reduction and internal fixation, but it has some disadvantages that interfere with fracture healing. 5,7,8 In a prospective study by Im and Tae, nailing showed an advantage in operating time, movement and wound problems, but anatomical plates produced better alignment. 9 Malrotation was better restored in the MIPO group.…”

Section: Discussionmentioning

confidence: 99%

A preliminary comparison between intramedullary interlocking nail and minimally invasive plate osteosynthesis in extra-articular distal tibia fractures: a retrospective study

Baral

Raj

2017

SA orthop. j.

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Aims: To compare functional outcome between intramedullary interlocking nail (IMIL) versus minimally invasive plate osteosynthesis (MIPO) in the distal one-third extra-articular tibia fracture. Patients and methods:We retrospectively analysed 42 cases (21 each) of the IMIL nail versus locking plate by MIPO technique. All patientswere followed for at least one year since the last case operated. This study included closed distal tibia fractures above 4 cm to 10 cm and fibula fractures. Fibula fractures within 7 cm of the tibial plafond were fixed with Kirschner wire (K-wire). We excluded all comminuted open fractures, intra-articular extension, and isolated fracture of the tibia from the study. Foot function index, union time, rotational and angular malalignment, rate of infection, secondary interventions and complications were compared between the groups.Results: All patients were retrospectively analysed. Coronal (P=0.259) and sagittal plane malalignment (P=0.147), distraction (P=0.147), rotation (P=0.147), delayed union (P=0.549), non-union (P=0.311), infection (P=0. 549), malunion (P=0.147), amputation (P=0.311), secondary intervention (P=0.116), and foot function index (P=0.217) were all similar between the groups. Time to union was earlier in the MIPO group (P=0.033). We, however, used the MIPO technique in the younger age groups (P=0.042). Coronal plane deformity in both groups was associated with a higher rate of complications, which was also statistically significant (P=0.012). Conclusion:Our study suggests that similar outcomes appear through IMIL nail and MIPO of distal extra-articular tibia fractures. Time to union was faster in the MIPO cases, but other factors, such as age, might have played a role. Level of evidence: Level 3Key words: intramedullary interlocking nail, minimally invasive plate osteosynthesis, alignment, distal tibia

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“…Our study did not investigate orthopaedic postoperative complications such as nonunion, malunion and hardware which are commonly associated with surgical fixation of lower extremity long bone fractures. 15,[22][23][24][25][26] Social factors such as addiction and homelessness have also shown to affect outcomes of bone healing, 11 and were not evaluated in this study. Due to the nature of the database, our study was only able to evaluate complications within 30 days following surgery.…”

Section: Discussionmentioning

confidence: 99%

Increased risk of adverse events in management of femur and tibial shaft fractures with plating: An analysis of NSQIP data

Dodd¹,

Salib²,

Lakomkin³

et al. 2016

Journal of Clinical Orthopaedics and Trauma

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Treatment of distal tibial shaft fractures by three different surgical methods: a randomized, prospective study

Cited by 94 publications

References 40 publications

Is intramedullary nailing applicable for distal tibial fractures with ankle joint extension?

Is intramedullary nailing applicable for distal tibial fractures with ankle joint extension?

A preliminary comparison between intramedullary interlocking nail and minimally invasive plate osteosynthesis in extra-articular distal tibia fractures: a retrospective study

Increased risk of adverse events in management of femur and tibial shaft fractures with plating: An analysis of NSQIP data

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