Do Poller screws effect union in tibial shaft fractures treated with intramedullary nailing?

Peat, Fidel; Ordas-Bayon, Alejandro; Krkovič, Matija

doi:10.1016/j.injury.2021.02.040

Cited by 6 publications

(20 citation statements)

References 33 publications

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“…Another study of 154 diaphyseal tibia fractures treated with medullary nailing also found a decreased nonunion rate in patients treated with adjunctive blocking implants. 29 No increase was observed in infection or revision surgery in any group. A case study of two patients with proximal-third nonunion showed uncomplicated healing after dynamization and the addition of a blocking screw.…”

Section: Recent Clinical Evidencementioning

confidence: 79%

Updated Blocking Techniques for Lower Extremity Medullary Nailing: Beyond the Concavity of Deformity

DeBaun

Barei

Ricci

et al. 2023

J Am Acad Orthop Surg

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Modern blocking techniques are useful to achieve anatomic alignment and stable fixation during end-segment nailing. Whether with screws or drill bits, blocking implants can correct both angular and translational deformities. Understanding the biomechanics of blocking implants allows the surgeon to properly plan their placement based on principles rather than dogma. We use case examples to highlight updates in blocking techniques during acute surgical fixation and chronic deformity correction.

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Section: Recent Clinical Evidencementioning

confidence: 79%

Updated Blocking Techniques for Lower Extremity Medullary Nailing: Beyond the Concavity of Deformity

DeBaun

Barei

Ricci

et al. 2023

J Am Acad Orthop Surg

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“…When only RCT articles were included, the number of references did not support the analysis. After reading the full text, 20 articles [12,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] were finally included and used to provide primary data for further analysis, there were 4 randomized controlled trials, [31][32][33]36] 16 case-control studies, [12,[25][26][27][28][29][30]34,35,[37][38][39][40][41][42][43] 5 English literatures [12,[25][26][27]41] and 15 Chinese literatures, [28][29][30][31][32]<...…”

Section: Search Resultsmentioning

confidence: 99%

“…(3) 21 Yang ZY 2012 [39] China CCT BS vs NBS 17 20-67 (1)(3)(4)(6) 15 Meng LH 2021 [34] China CCT BS vs NBS 25 38.73 ± 12.85 (1)(2)(3)(4)(5) 23 36.85 ± 12.77 Wang B 2019 [36] China RCT BS vs NBS 21 64.62 ± 3.14 (3)(4)(6) 21 64.58 ± 3.41 Yang GH 2015 [38] China CCT BS vs NBS 18 43.85 ± 11.91 (1)(2)(3)(4) 17 Peat 2021 [41] Britain CCT BS vs NBS 88 / (4) 66 Guo 2021 [26] China CCT BS vs NBS 33 43.9 ± 16.9…”

Section: Age (Year) Outcomementioning

confidence: 99%

“…The Newcastle-Ottawa scale score of non-RCT. Bryan 2018 [27] 1 1 0 1 2 1 1 1 8 Adam 2019 [12] 1 1 0 1 2 1 1 1 8 Ross 2019 [25] 1 1 0 1 2 1 1 1 8 Guo WY 2020 [29] 1 1 0 1 1 1 1 1 7 Wang GH 2019 [37] 1 1 0 1 1 1 1 1 7 Chen HQ 2021 [28] 1 1 0 1 2 1 1 1 8 Hou JZ 2016 [30] 1 1 0 1 2 1 1 1 8 Pan YF 2013 [35] 1 1 0 1 1 1 1 1 7 Zhang YY 2018 [40] 1 1 0 1 1 1 1 1 7 Yang ZY 2012 [39] 1 1 0 1 2 1 1 1 8 Meng LH 2021 [34] 1 1 0 1 1 1 1 1 7 Yang GH 2015 [38] 1 1 0 1 1 1 1 1 7 Peat 2021 [41] 1 1 0 1 2 1 1 1 8 Guo 2021 [26] 1 1 0 1 2 1 1 1 8 Huang JP 2022 [43] 1 1 0 1 1 1 1 1 7 Wei XJ 2022 [42] 1 than that in NBS group (OR = 3.56; 95% CI = 1.43-8.89, P = .006; Fig. 12).…”

Section: Tablementioning

confidence: 99%

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Clinical efficacy and complications of blocking screw in the treatment of lower limb long bone fracture: An updated systematic review and meta-analysis

Chen,

Chen

2024

Medicine

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Background: Blocking screw technique has been widely applied in the treatment of long shaft fractures. However, the evidence with regard to whether intramedullary nail combined with blocking screw technique has better clinical efficacy over other is not clear. The aim of the study was to explore the clinical efficacy and complications of intramedullary nail combined with blocking screw technique in the treatment of femoral or tibial shaft fractures. Methods: The PuMed, Embase, OVID, Cochrane library, Web of Science, Wanfang, CNKI and Weipu data were searched for studies of intramedullary nail combined with blocking screw in treatment of femoral or tibial shaft fracture published up to Aug 31 2023. Methodological quality of the trials was assessed, relevant data were extracted, and RevMan 5.3 and Stata 15.0 software were used to perform the meta-analysis of parameters related to the consequences. Result: Twenty articles were included, including 1267 patients. Meta-analysis results showed that compared with the non-blocking screw group, the blocking screw group had longer operation time (WMD = 13.24; 95% CI = 5.68–20.79, P = .0006) and more intraoperative fluoroscopy times (WMD = 57.62; 95% CI = 25.82–89.42, P = .0002). However, the postoperative therapeutic response rate was higher (OR = 5.60; 95% CI = 2.10–14.93, P = .0006), postoperative ankle joint function was better (OR = 3.48; 95% CI = 1.20–10.13, P = .02), and fracture healing rate was higher (OR = 3.56; 95% CI = 1.43–8.89, P = .006), fracture healing time was shorter (WMD = −3.59; 95% CI = −4.96 to −2.22, P < .00001), intraoperative blood loss was less (WMD = −54.80; 95% CI = −88.77 to −20.83, P = .002), hospitalization time was shorter (WMD = −1.66; 95% CI = −2.08 to −1.24, P < .00001), and complications were less (OR = 0.38; 95% CI = 0.16–0.89, P = .01). There was no statistical significance in the range of motion of knee joint between the 2 groups (WMD = 10.04; 95% CI = −1.51 to 21.59, P = .09). Conclusions: Current evidence shows that intramedullary nail combined with blocking screw technique in the treatment of lower limb long bone fracture has the advantages of good clinical efficacy, high fracture healing rate, short fracture healing time, good joint function, less complications and so on, which is worthy of clinical recommendation.

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“…Nailing in flexion Patellar tendon-splitting approach 1,2 Medial parapatellar tendon 3 Extended/semiextended nailing 4 Medial parapatellar 5 Suprapatellar/retropatellar 6,7 Extra-articular 8 Tools Reduction clamp 2,9,10 /Schanz screw 1,10 / External fixator 9,11 /Large femoral distractor 1,9 Unilateral 1,12 Bilateral 12 Poller screws [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] Temporary 13,14,25 Permanent 13,14,25 Supplemental plate 2 Temporary 29 Permanent 2,29 [4][5][6][7][8] differ from the patellar tendon-splitting approach. 1,2 For the patellar tendon-splitting approach, it is important to start high, that is, at the level of the distal third of the patella, to be able to create a steep bone channel and keep the incision limited (Figs.…”

Section: Positions/approachesmentioning

confidence: 99%

Avoiding deformity in proximal tibial nailing: risk factors, deformity rules, tips, and tricks

Krettek

Edwards

2023

OTA International: The Open Access Journal of Orthopaedic Trauma

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Summary:Malalignment is one of the most common problems linked to nailing of proximal tibial fractures. This review will cover technical aspects of intramedullary nailing and will help explain the various risk factors. Deformity rules aid in identifying the likely deformity and help to develop management strategies. Various tools and techniques are discussed which can help optimize the outcome.Level of Evidence:Therapeutic Level V

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Do Poller screws effect union in tibial shaft fractures treated with intramedullary nailing?

Cited by 6 publications

References 33 publications

Updated Blocking Techniques for Lower Extremity Medullary Nailing: Beyond the Concavity of Deformity

Updated Blocking Techniques for Lower Extremity Medullary Nailing: Beyond the Concavity of Deformity

Clinical efficacy and complications of blocking screw in the treatment of lower limb long bone fracture: An updated systematic review and meta-analysis

Avoiding deformity in proximal tibial nailing: risk factors, deformity rules, tips, and tricks

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