Modified Tibial Nails for Treating Distal Tibia Fractures

Gorczyca, John T.; Mckale, James; Pugh, Kevin J.; Pienkowski, David

doi:10.1097/00005131-200201000-00004

Cited by 95 publications

(56 citation statements)

References 7 publications

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“…A further option for metaphyseal fractures located 4-5 cm proximal to the ankle joint is intra-medullary nailing, possibly cutting one centimetre off the tip of a tibial nail thus allowing placement of two distal interlocking screws [9,13]. However, fixation strength with these distal fractures is not high enough to resist even moderate compression and bending loads.…”

Section: Discussionmentioning

confidence: 99%

“…However, fixation strength with these distal fractures is not high enough to resist even moderate compression and bending loads. Thus, patients with distal tibia fractures treated with intra-medullary nailing must follow weight-bearing restrictions until significant fracture healing occurs to prevent malalignment [9]. Also, this technique is ill-suited to the management of the intra-articular component of distal tibial fractures.…”

Section: Discussionmentioning

confidence: 99%

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Percutaneous plating of distal tibial fractures

Maffulli

Toms

McMurtie

et al. 2004

International Orthopaedics

110

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We studied 20 patients (mean age 47.9€3.9, range 25-85 years) undergoing percutaneous plating of the distal tibia for 43A or 43C fractures in the period 1999-2002. Bony and functional results were classified into four categories ranging from excellent to poor. Union was achieved in all but one patient. Seven patients had angular deformities between 7 and 10, but none of these patients required further operations. No patient had a leglength discrepancy greater than 1 cm. Thirteen patients had excellent and good bone results, and none used walking aids. Seven patients reported stiffness of the operated ankle. This reported use of percutaneous techniques in the management of fractures of the distal tibial metaphysis is preliminary. However, the functional results and the lack of soft tissue complications are encouraging.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Percutaneous plating of distal tibial fractures

Maffulli

Toms

McMurtie

et al. 2004

International Orthopaedics

110

View full text Add to dashboard Cite

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“…It is also well documented that the placement of two distal screws increases the stiffness and strength of the bone-implant construct, thus leading to enhanced mechanical stability of the fixed fracture. 20 In our series distal tibial fractures were treated with a reamed intramedullary nailing system that increases distal fixation by two distal interlocking screws passing through the distal 0.5 cm to 1.5 cm from the tip of the nail. The design of the nail allows one mediolateral and one anteroposterior screw for better stabilization of the distal fragment.…”

Section: Figure 6: Showing Distribution Post-operative Complications mentioning

confidence: 99%

Role of tibia interlocking nail in treating distal tibial metadiaphyseal fractures: study of 46 cases

et al. 2017

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Background: Distal tibial diaphyseal fractures are known for its various challenges that orthopaedicians face while treating. While performing surgery, many principles of fixations are needed to be properly addressed. This study was undertaken to know the efficiency of closed reduction, polar screws and tibia interlocking nail fixation at our Institute.Methods: The data, which were collected from the medical records and Department digitalised storage system and from the HMIS patient filing system, included age, sex, date of admission, type of admission (elective versus emergency), and AO classification of distal tibial fracture admitted in Orthopaedics Department from 2007 to 2013. Analyses of 46 cases, 34 males and 12 females, were made to find out the functional, radiological outcome, associated complications in treating distal tibia with ILN. During Analysis, association of the single event with the variables was estimated using Relative Risk, with a 95% confidence interval and P value of <0.05 was considered significant.Results: The average time to union of the closed fracture was 15.4 weeks (range: 12–28 weeks). The healing times for the primarily nailed compound Grade I averaged 17.8 weeks (range: 15-34 weeks). Complications of delayed union occurred in 3 cases, and two cases of non-union. Infection in 6 cases (5 superficial, 1 deep), screw breakage in 4 cases and 3 cases of significant malalignment. The final functional outcome of 33 patients had excellent results, 11 had good results and 2 had fair results as determined by criteria of Johner and Wruh. Conclusions: The dynamic osteosynthesis of distal tibia by interlocking nail and judicious use of poller screws is an effective alternative for the treatment of distal metaphyseal tibial fractures.

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“…Studies demonstrate the benefits of differing implants used on different individuals with dissimilar injuries in disparate time periods. [16][17][18][19] Although the finer points of technique may be debated, without the required surgical skills, the prognosis is threatened regardless of which philosophy is chosen. With concerns evident regarding the training of junior doctors, [20][21][22][23] it is timely to assess the experiences of current UK orthopaedic trainees.…”

Section: Discussionmentioning

confidence: 99%

Training in the practical application of damage control and early total care operative philosophy – perceptions of UK orthopaedic specialist trainees

Eardley¹,

Taylor²,

Parker

2010

annals

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INTRODUCTION Despite improvements in the outcome of individuals sustaining significant injury, the optimum management of fractures in traumatised patients remains an area of debate and publication. There is, however, a paucity of studies regarding the specifics of acquired experience and training of junior orthopaedic surgeons in the practical application of these skills. Our null hypothesis is that, despite alteration in surgical training, the perceived confidence and adequacy of training of UK orthopaedic specialist trainees in the application of damage control orthopaedics (DCO) and early total care (ETC) philosophy is unaffected. PATIENTS AND METHODS A web-based survey was sent to a sample of orthopaedic trainees. From 888 trainees, 222 responses were required to achieve a 5% error rate with 90% confidence. RESULTS A total of 232 responses were received. Trainees reported a high level of perceived confidence with both external fixation and intramedullary devices. Exposure to cases was sporadic although perceived training adequacy was high. A similar pattern was seen in perceived operative role with the majority of trainees expecting to be performing such operations, albeit under varying levels of supervision. In a more complicated case of spanning external fixation for a ‘floating knee, trainees reported a decreased level of perceived confidence and limited exposure. One-third of trainees reported never having been involved in such a case. In contrast to nationally collated logbook data, exposure to and perceived confidence in managing cases involving ETC and DCO were similar. CONCLUSIONS Despite changes in the training of junior orthopaedic surgeons, trainee-reported confidence and adequacy of training in the practical application of DCO and ETC was high. Exposure to cases overall was, however, seen to be limited and there was a suggestion of disparity between current operative experiences of trainees and that recorded in the national trainee logbook.

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Modified Tibial Nails for Treating Distal Tibia Fractures

Cited by 95 publications

References 7 publications

Percutaneous plating of distal tibial fractures

Percutaneous plating of distal tibial fractures

Role of tibia interlocking nail in treating distal tibial metadiaphyseal fractures: study of 46 cases

Training in the practical application of damage control and early total care operative philosophy – perceptions of UK orthopaedic specialist trainees

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