Fixator-assisted nailing of tibial fractures: New surgical technique and presentation of first 30 cases

Semenistyy, Anton A; Litvina, E. A; Fedotova, A. G; Gwam, Chukwuweike U.; Миронов, А. Н.

doi:10.1016/j.injury.2018.11.015

Cited by 12 publications

(8 citation statements)

References 8 publications

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“…In the past, various authors have reported the modification of standard reduction and fixation techniques for complex fractures of the tibia to overcome the intraoperative difficulties and still be able to follow the principles of minimal soft tissue damage and preserve blood supply to the bone by minimizing periosteal stripping. These modifications include a variety of options such as combining external and internal locking plates [ 9 ], clothesline technique during IMN [ 8 ], using Farabeuf clamp during undreamed nailing [ 10 ], application of large pointed reduction forceps [ 11 ], a temporary application of unicortical plates to prevent malalignment [ 12 ] and most recently FAN for difficult tibial fractures [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Second, the fixator holds the intercalary segment preventing the axial rotational, thereby minimizing injury to the remaining periosteal blood supply. To the best of our knowledge, although Semenistyy et al [ 13 ] reported FAN in the acute phase, there is no described technique in the literature to address these two keys steps together. However, no technique is without its risks.…”

Section: Discussionmentioning

confidence: 99%

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“Fixator-assisted Nailing” Technique for Closed Segmental Tibia Shaft Fracture with Extensive Soft Tissue Injury – A Case Report

Sodhai¹,

Pradhan²,

Sancheti³

et al. 2021

JOCR

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Introduction: Segmental tibia fractures with extensive soft tissue injuries are rare and surgical intervention is challenging with no definitive treatment strategies. Case Report: A 52-year-old man presented with closed right segmental tibia and fibula fracture with extensive blistering of skin caused due to road traffic accident. Distal pulses were palpable and there were no signs of compartment syndrome and other systemic injuries. In the presence of extensive blistering, a monoplanar external fixator was applied within 24 h of injury. 3 weeks later, skin condition was conducive for internal fixation, and closed intramedullary multi-locking nailing was performed using the external fixator for reduction. Fracture healed at 15 months and patient had an excellent functional outcome with full knee range of motion at 2-years follow-up without any complications. Conclusion: Fixator-assisted nailing is a simple, minimally invasive, and easily reproducible technique that is useful in reducing the fracture and preventing axial rotation of the intercalary segment minimizing the damage to the periosteal blood supply. Our case also highlights the importance of temporary external fixator in soft tissue healing and making the skin conducive for internal fixation. Keywords: Devascularization, fixator-assisted nailing, intercalary segment, rotational displacement, segmental tibial fracture.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“Fixator-assisted Nailing” Technique for Closed Segmental Tibia Shaft Fracture with Extensive Soft Tissue Injury – A Case Report

Sodhai¹,

Pradhan²,

Sancheti³

et al. 2021

JOCR

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“…В группе 1 методика фиксатор-ассистированного интрамедуллярного остеосинтеза не использовалась. В группе 2 мы применяли технику ФАИМО на основе тубулярного аппарата наружной фиксации по описанной авторами методике у 32 (68,7%) пациентов [23].…”

Section: алгоритм выполнения интрамедуллярного остеосинтезаunclassified

Classification of Proximal Tibial Fractures and Algorithm of Intramedullary Nailing: Efficacy Evaluation

Semenistyy

Litvina

Миронов

2021

Traumatology and Orthopedics of Russia

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Background. Intramedullary nailing of proximal tibial fractures is challenging due to difficulties with fracture reduction and achievement of stable fixation. Preoperative planning based on proximal fragment length, fracture pattern and bone quality evaluation is a prerequisite for a successful operation. However, there is no classification that could adequately access these factors and guide us towards the most effective methods of fracture reduction and fixation with intramedullary nail. The purpose of this study was to evaluate a classification of extra-articular proximal tibial fractures and algorithm for intramedullary nailing in clinical conditions. Materials and Methods. We compared the treatment outcomes before (Group 1) and after (Group 2) the introduction of the new PFL-TN classification algorithm of intramedullary nailing of proxamal tibial fractures. The group 1 included 43 patients from 18 to 71 years old (males 28; females 15; average age 44.52.0 years). The group 2 included 42 patients from 18 to 72 years old (males 30; females 12; average age 46.12.0 years). The data analysis was carried out after a minimum follow-up period of 12 months. The results were analyzed by the following criteria: reduction quality assesed with reduction quality scale, number of complications, quality of life with SF-36 questionnaire and leg function with LEFS scale. Results. The introduction of the proposed algorithm allowed to reduce the number of late complications by more than 5 times, and the number of required additional surgical interventions by more than 4 times compared to with a control group. The introduction of the proposed algorithm made it possible to improve the functional outcomes 1 year after surgery from 83.58 to 93.29% (p = 0.00002) by the LEFS scale, and the patients quality of life from the 77.501.88 to 86.712.03 points (p = 0.00072) and from the 81.251.88 to 86.842.26 points (p = 0.00116) by the physical and role functioning scales SF-36 questionnaire. Conclusion. The proposed algorithm, based on the new classification, allows to optimize the surgical technique of intramedullary nailing of proximal tibial fractures.

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“…Traction Technique 8 , Esmarch technique 9 , external xators 6 and sustained traction via fracture table 10 .…”

Section: Elastic Bandagementioning

confidence: 99%

“…However, some unstable tibial fractures types including periarticular fracture, segmental and comminuted fracture and accompanying with bula fracture, are considered as di cult nailing group 5,6 . Numerous techniques have been described to facilitate xation, such as reduction clamps 7…”

Section: Introductionmentioning

confidence: 99%

Application of the Distraction Support in Intramedullary Nailing Treatment for Tibial Shaft Fracture: A Randomized Controlled Study

Yao

Mao

et al. 2020

Preprint

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Purpose The aim of this study is to investigate the effectiveness of using a new distraction support in intramedullary nailing treatment for tibial shaft fracture.Methods: Patients at the trauma center who underwent the treatment for tibial shaft fractures from July 2013 to December 2018 were enrolled. The patients were randomized in control group(n=43) and distraction support(SD) group(n=42). All operations were performed by the same senior surgeon. The hospital day, blood loss, operative time, infect rate, delayed union rate and malalignment rate(p=0.68) were obtained for the evaluation.Results: 85 participants were recruited and all cases were achieved the acceptable reduction. The operative time was significantly shorter for DS group than control group (75.3 vs.90.4 p<0.001). Blood loss was significantly lower in the DS group compared to the control group(60.1vs.85.4 p=0.003) . There were no obvious difference about infect rate(p=0.98), delay union(p=0.45), hospital days(p=0.37) and malalignment rate(p=0.68) between the two groups.Conclusion: Distraction support was effective in intramedullary nailing surgery. The application of distraction support may be a useful method in our future work.

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Fixator-assisted nailing of tibial fractures: New surgical technique and presentation of first 30 cases

Cited by 12 publications

References 8 publications

“Fixator-assisted Nailing” Technique for Closed Segmental Tibia Shaft Fracture with Extensive Soft Tissue Injury – A Case Report

“Fixator-assisted Nailing” Technique for Closed Segmental Tibia Shaft Fracture with Extensive Soft Tissue Injury – A Case Report

Classification of Proximal Tibial Fractures and Algorithm of Intramedullary Nailing: Efficacy Evaluation

Application of the Distraction Support in Intramedullary Nailing Treatment for Tibial Shaft Fracture: A Randomized Controlled Study

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Fixator-assisted nailing of tibial fractures: New surgical technique and presentation of first 30 cases

Cited by 12 publications

References 8 publications

“Fixator-assisted Nailing” Technique for Closed Segmental Tibia Shaft Fracture with Extensive Soft Tissue Injury – A Case Report

“Fixator-assisted Nailing” Technique for Closed Segmental Tibia Shaft Fracture with Extensive Soft Tissue Injury – A Case Report

Classification of Proximal Tibial Fractures and Algorithm of Intramedullary Nailing: Efficacy Evaluation

Application of the Distraction Support in Intramedullary Nailing&nbsp;Treatment for Tibial Shaft Fracture: A Randomized Controlled Study

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Application of the Distraction Support in Intramedullary Nailing Treatment for Tibial Shaft Fracture: A Randomized Controlled Study