Nonreamed Interlocking Nailing of Closed Tibial Fractures With Severe Soft Tissue Injury

Krettek, Christian; Schandelmaier, P.; Tscherne, H.

doi:10.1097/00003086-199506000-00005

Cited by 81 publications

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“…The number of pseudoarthroses may indicate low stability at the fracture site. The rate of metal failure has been higher than in previous series [8,14,15,17,30,31]. This could be explained since, as we were encouraged by the initial results and by our experience with reamed nails, we encouraged early weightbearing which is not recommended with this type of osteosynthesis.…”

Section: Discussionmentioning

confidence: 87%

“…Singer et al had a high index of broken locking screws, but their results are comparable with other types of external fixation [23]. This kind of nail has also been used in closed tibial fractures, which are unstable or have severe soft tissue injury, with breakage of cross-locking screws in 15% [8,17]. The management of soft tissue injury has improved with the use of pedicle flaps and free vascularised grafts, which allow more aggressive initial debridement and diminish the importance of the type of osteosynthesis used [10,21,27].…”

Section: Discussionmentioning

confidence: 99%

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Unreamed intramedullary locking nailing for open tibial fractures

García-López

Marco

López-Durán

1998

International Orthopaedics

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Unreamed intramedullary locking nailing for open tibial fractures

García-López

Marco

López-Durán

1998

International Orthopaedics

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“…Its advantages include stable fixation, early mobilisation and soft tissues preservation with easier patient care, particularly with multiple injuries [10][11][12]. New locking facilities have made stabilising nonisthmic fractures possible without interference fitting [4,13,14].…”

Section: Introductionmentioning

confidence: 99%

“…New locking facilities have made stabilising nonisthmic fractures possible without interference fitting [4,13,14]. Moreover, unreamed nailing, by preserving the endosteum, has been shown to be advantageous in polytrauma patients and in decreasing the incidence of infection in high-energy fractures [10][11][12]. Initial enthusiasm, however, was later followed by contradictory reports showing a relatively higher rate of delayed union, implant failure and reoperations after its widespread use [2,15,16].…”

Section: Introductionmentioning

confidence: 99%

Unreamed intramedullary nailing in distal tibial fractures

Salem

2013

International Orthopaedics (SICOT)

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Purpose Unreamed nailing has gained acceptance in the treatment of diaphyseal long bone fractures, especially in cases with polytrauma or high-energy injuries. Its application in distal tibial fractures, however, remains controversial. Methods In this study, 101 distal tibial fractures treated using closed unreamed nailing were reviewed after a mean followup of 32 months. There were 59 type A und 42 type B fractures. The most common fracture pattern was the A1 spiral fracture (n = 40) followed by the B2 wedge fracture (n = 18). Intra-articular extension was encountered in 14 cases. One-fourth of the patients (n = 24) had open injuries. Forty-seven patients had additional injuries, and nearly onethird of them were polytraumatised. Results Union occurred after a mean time of 23.9 (range, 11-134) weeks. There were 13 cases of delayed union and seven non-unions; all healed eventually with additional surgery in only six fractures. Malunion was seen in 12 cases (five valgus, two varus and five external torsion), ten of which were associated with unplated fibular fractures. Three fractures (two open) were treated for deep infection. The most common complication seen was fatigue failure of the locking screws (27 cases). Conclusions Unreamed nailing of distal tibial fractures is associated with a rather high rate of bone healing complications and locking screw failure. The decision for its use in the notoriously challenging fractures of this segment should be critically considered.

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“…7,8 Reaming of the medullary canal may lead to vascular damage and thermal necrosis of the tibia. 9 The recent use of locked intramedullary nail has shown promising results. 10 It has also given satisfactory result in proximal third tibial shaft fracture and segmental tibial shaft fracture.…”

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confidence: 99%

Functional Outcome of Interlocking Nailing of Type I and Ii Compound Fracture Tibia

Baby¹,

Kunjappan²

2018

jemds

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BACKGROUND Introduction of closed locked intramedullary nailing has revolutionised the management of fractures of femur and tibia. The study is to prove type-I and type-II open fractures with comparatively less soft tissue damage and contamination, can be safely managed by debridement, early wound care and an unreamed/ reamed interlocking nailing without any deep infection hence allowing early mobilisation, reducing morbidity, reducing reoperation/ secondary procedures and malunion/ non-union. MATERIALS AND METHODSA prospective observational study was approved by the Hospital Ethical Committee and an informed consent was taken from all patients. 30 patients who underwent IL nailing from March 2011 to 2012 were enrolled in this study. Of the 30 patients, 17(56.7%) patients had fracture in right tibia and 13(43.3%) had fracture in left tibia. Age of the patients ranged from 18 to 65 years with mean age being 35.5. Males dominated (73.3%) in this study population and the sex ratio was found to be 2.75. Females were represented by only 26.7%. RESULTSIn this study all the cases united irrespective of the Gustilo and Anderson (G and A), OTA classification, Level of fracture and Mode of injury. Time of union ranges between 15 to 24 weeks with mean time of union is 20.1. Shortest time for a union was within 15 weeks (1 case) which was grade I Gustilo and Anderson, middle 3 rd , transverse, OTA-A fracture and maximum time taken was a period of 24 weeks (2 cases) which were type II, lower3 rd fractures. From this, it is observed that there is a difference in union rate between Level, Gustilo and Anderson, and OTA classifications. In this study, it is observed that there were no cases of deep infection. CONCLUSIONClosed interlocking intramedullary nailing is an effective method of treatment for Gustilo and Anderson type I and II compound tibial diaphyseal fractures. It is based on the principle of promoting biological healing and allows gradual weight bearing. Closed nailing and static locking is a technically demanding procedure. Risk of exposure to radiation is there. This method offers the possibility of maintenance of length, alignment and rotational stability in fractures of the tibial shaft, while preserving the biological environment of fracture healing. The fixation is rigid, hence there is no need for external immobilisation prior to callus formation and weight bearing. KEYWORDSCompound Fracture Tibia, Gustilo and Anderson (G and A) Classification, Interlocking Intramedullary Nailing. HOW TO CITE THIS ARTICLE: Baby S, Kunjappan MM. Functional outcome of interlocking nailing of type I and II compound fracture tibia.

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Nonreamed Interlocking Nailing of Closed Tibial Fractures With Severe Soft Tissue Injury

Cited by 81 publications

References 0 publications

Unreamed intramedullary locking nailing for open tibial fractures

Unreamed intramedullary locking nailing for open tibial fractures

Unreamed intramedullary nailing in distal tibial fractures

Functional Outcome of Interlocking Nailing of Type I and Ii Compound Fracture Tibia

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