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

Toivanen, Jarmo; Honkonen, Seppo E.; Koivisto, Anna‐Maija; Järvinen, Markku

doi:10.1007/s002640000083

Cited by 43 publications

(25 citation statements)

References 19 publications

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“…This is achieved by either nonoperative treatment or by surgery, using reamed or unreamed intramedullary nailing, open reduction and internal fi xation (ORIF), and external fi xation [1][2][3][4][5][6] . Locking Grosse and Kempf (GK) intramedullary nail was introduced in 1974.…”

Section: Introductionmentioning

confidence: 99%

Closed and Open Grade I and II Tibial Shaft Fractures Treated by Reamed Intramedullary Nailing

Djahangiri

Garofalo²,

Chevalley³

et al. 2006

Med Princ Pract

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Objective: To evaluate the results of closed and open grade I and II tibial shaft fractures treated by reamed nail and unreamed nailing. Subjects and Methods: Between 1997 and 2000, 119 patients with tibial shaft fractures were treated with reamed tibial nails. Postoperatively 96 patients (70 closed and 26 grade I and II open fractures) were followed clinically and radiologically for up to 18 months. The nail was inserted either by patellar tendon splitting or by nonsplitting technique. The nail was inserted after overreaming by 1.5 mm. Postoperatively, patients with isolated tibial fracture were mobilized by permitting partial weight bearing on the injured leg for 6 weeks. Patients with associated ankle fractures were allowed to walk with a Sarmiento cast. Results: Postoperatively, 6 (6.3%) patients developed a compartment syndrome after surgery. In 48 (50%) cases, dynamization of the nail was carried out after a mean period of 12 weeks for delayed union. Overall, a 90.6% union was obtained at a mean of 24 weeks without difference between closed or open fractures. Two (2.1%) patients with an open grade II fracture developed a deep infection requiring treatment. A 9.4% rate of malunion was observed. Eight (8.3%) patients developed screw failure without clinical consequences. At the last follow-up, 52% of patients with patellar tendon splitting had anterior knee pain, compared to those (14%) who did not have tendon splitting. Conclusion: Reamed intramedullary nail is a suitable implant in treating closed as well as grade I and II open tibial shaft fractures.

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Section: Introductionmentioning

confidence: 99%

Closed and Open Grade I and II Tibial Shaft Fractures Treated by Reamed Intramedullary Nailing

Djahangiri

Garofalo²,

Chevalley³

et al. 2006

Med Princ Pract

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“…We considered a fracture united when radiographs showed mature callus bridging the major fragments on at least one radiographic projection and the patient was walking without pain or external support. Time to healing did not differ from analyses of the distal and proximal fractures of the tibia [28,50].…”

Section: Methodsmentioning

confidence: 82%

Fractures of the Middle Third of the Tibia Treated with a Functional Brace

Sarmiento

Latta

2008

Clinical Orthopaedics &Amp; Related Research

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“…Ayrıca cerrahiye bağlı komplikasyonlar bu yön-temlerde gözlenmez. Ancak bu hastalarda uzun süre hareketsiz kalmaya bağlı eklem sertlikleri, rotasyon, kısalık, açılanma, kaynama gecikmesi gibi komplikasyonlara sık rastlanmaktadır [10,11,12]. Kapalı olarak uygulandığında kırık hematomunun sağladığı kaynama kolaylığı, erken yük vermeye olanak sağlaması, güvenilir tespit sağlaması ve düşük komplikasyon oranları ile intramedül-ler çiviler tibia cisim kırıklarının tedavisinde çok sık tercih edilmektedir [1][2][3].…”

Section: Discussionunclassified

Results in the Treatment of Tibial Diaphyseal Fractures with Expandable Intramedullary Nails

Serbest¹

2015

Ann Clin Anal Med

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ÖzetAmaç: Tibia şaft kırıklarında genişleyebilir intramedüller çivilerin klinik kullanımı, etkinliği ve kısa dönem sonuçları araştırıldı. Gereç ve Yöntem: Tibia şaft kırığı olan 22 hasta (9 kadın, 13 erkek; ort. yaş 33; dağılım 21-65) çalışmaya alındı. Tüm hastalarda kapalı kırık vardı. Tüm hastalarda genişleyebilir intramedüller çiviyle internal tespit uygulandı. Kırık oluşumundan ameliyata kadar geçen süre ortalama 2,5 gün (dağılım 12 saat-5 gün) idi. Sonuçlar JohnerWrush ve Kalstrom-Olerud ölçütlerine göre değerlendirildi. Hastalar ortalama 10 ay (dağılım 7-21) izlendi. Bulgular: Tüm olgularda kaynama sağlandı. Tibia kırıklı hastalarda ameliyat süresi ortalaması 45 dakika (25-80 dakika); kaynama süresi ortalaması 10 hafta (7-21 hafta) bulundu. Johner-Wrush kriterlerine göre 14 hastada (% 63,6) mükemmel, 7 hastada (% 31.8) iyi sonuç, bir hastada (% 4.5) orta sonuç elde edildi. Kalstrom-Olerud ölçütlerine göre 17 hastada (% 77.2) mükemmel, 5 hastada (% 22.7) iyi sonuç alındı. Gecikmiş kaynama, erken veya geç enfeksiyon, kompartman sendromu gibi komplikasyonlar görülmedi. Tartışma: Sonuçlarımız, şişirilebilir intramedüller çivilerin tibia kırıklarının tedavisinde hızlı, basit ve etkili bir çözüm sağlayan, klasik çivilere alternatif bir yöntem olduğunu göstermektedir. Anahtar KelimelerTibia Diafiz Kırıkları; İntramedüller Çivileme; Şişirilebilir Çivi Abstract Aim: We investigated the use of expandable intramedullary nails, their efficacy, and short-term results in the treatment of tibia shaft fractures. Material and Method: The study included 22 patients (9 females, 13 males; mean age 33 years; range 21 to 65 years) who were treated with expandable intramedullary nails for the tibia shaft fractures. All patients had tibial fractures, all of which were closed. The mean duration from injury to surgery was 2,5 days (range 12 hours to 5 days). The results were evaluated using the Johner-Wrush and Kalstrom-Olerud criteria. The mean follow-up was 10 months (range 7 to 21). Results: Union was achieved in all the patients. In tibial fractures, the mean operation time was 45 minutes (range 25 to 80 min) and the mean time to union was 10 weeks (range 7 to 21 weeks). Results in 14 patients (63.6 %) were excellent, in 7 patients (31.8 %) good and in 1 patient (4.5 %) moderate according to Johner-Wrush criteria. Results in 17 patients (77.2 %) were excellent, in 5 patients (22.7 %) good according to Kalstrom-Olerud criteria. No complications were seen such as delayed union, early or late infections, compartment syndrome. Discussion: In conclusion, the good results of this study show that the expandable tibial intramedullary nail provides a successful option to classical intramedullary nails.

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

Cited by 43 publications

References 19 publications

Closed and Open Grade I and II Tibial Shaft Fractures Treated by Reamed Intramedullary Nailing

Closed and Open Grade I and II Tibial Shaft Fractures Treated by Reamed Intramedullary Nailing

Fractures of the Middle Third of the Tibia Treated with a Functional Brace

Results in the Treatment of Tibial Diaphyseal Fractures with Expandable Intramedullary Nails

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