Role of the fibula in the stability of diaphyseal tibial fractures fixed by intramedullary nailing

Galbraith, John G.; Daly, Charles J.; Harty, James; Dailey, Hannah L.

doi:10.1016/j.clinbiomech.2016.08.007

Cited by 9 publications

(4 citation statements)

References 33 publications

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“…[ 33 34 ] For ESIN of tibial fractures associated with a fibular fracture, additional retrograde pinning of the fibula contributes to effective stabilisation of the tibia. [ 1 35 ] No fibular fracture was pinned in our study.…”

Section: Discussionmentioning

confidence: 70%

Treatment of Long Bone Fractures in Children by Elastic Stable Intramedullary Nailing: Outcome and Challenges in a Unit with Restricted Technical Platform

Houegban

Goudjo

Metchihoungbe

et al. 2023

African Journal of Paediatric Surgery

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Introduction: Elastic stable intramedullary nailing (ESIN), developed by the Nancy school in France, is the gold standard for surgical treatment of long bone fractures in children. In Africa, few works have been devoted specifically to this technique. Objective: This study aimed to describe the outcome and to present the challenges with this technique in the treatment of long bone fractures in children. Patients and Methods: This was a prospective and descriptive study over 4 years including patients aged 0–15 years old operated using ESIN. Results: Sixty-two patients underwent ESIN, of whom 44 patients (70.96%) were for femur fractures, nine patients (14.52%) for tibia and fibula fractures and nine patients (14.52%) for humerus fractures. The majority of the patients treated with ESIN were children older than 6 years. Nine patients (14.51%) and 13 patients (20.98%) underwent ESIN following polytrauma and multiple fractures, respectively. Seven patients (11.29%) were operated on through-closed ESIN method. The unavailability of image intensifier (38.71%) and the presence of bone callus (40.32%) were the major reasons for using the open ESIN method. Thirty-three patients (53.23%) had minor or major complications. The majority of patients had satisfactory therapeutic outcomes. Conclusion: ESIN gives good results, even when the fracture site is approached.

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Section: Discussionmentioning

confidence: 70%

Treatment of Long Bone Fractures in Children by Elastic Stable Intramedullary Nailing: Outcome and Challenges in a Unit with Restricted Technical Platform

Houegban

Goudjo

Metchihoungbe

et al. 2023

African Journal of Paediatric Surgery

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“…In a study that investigated the need for fixation of the fibular fracture in this setting, authors suggested that both the severity of soft tissue injury and the healing capacity of the fibular fracture without fixation should be considered. However, results suggest that for midshaft tibial fractures, fibular plating may not effectively restore the tibial stability produced by an intact fibula and should not be performed unless fibular fixation is otherwise indicated [14]. In another study that investigated the effects of accompanying fibula fracture on the healing of tibial diaphysis fractures, it has been denoted that an intact fibula did not constitute a disadvantage for healing after intramedullary nailing and did not have any influence on the healing and angulation rates [2].…”

Section: Discussionmentioning

confidence: 99%

Does fibula fracture have an impact on tibial healing?

Karslı,

Tekin,

Öğümsöğütlü

et al. 2021

Ann Clin Anal Med

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Aim: Tibial diaphysis fractures are frequently-encountered fractures of the lower extremities. Fibula fracture may accompany these fractures. In this study, we investigated the effects of accompanying fibula fracture on the healing of tibial diaphysis fractures, which were treated by intramedullary nail fixation. Materials and Methods: Data of the patients who presented to our clinic and underwent intramedullary nailing for tibial diaphysis fractures between January 2016 and December 2018 were reviewed. Patients were divided into two groups based on the presence (Group 1) or absence (Group 2) of accompanying fibula fracture. Database which included information such as fracture type (open or closed fracture), fracture healing time, angulation, and smoking history were retrospectively analyzed. The effect of accompanying fibula fracture and other parameters on the healing time following intramedullary nail fixation of tibia diaphysis fractures was investigated. The Shapiro-Wilk, the Mann-Whitney U, and the Chi-Square tests were used for statistical analysis. Results: One hundred twenty-eight patients were included in this study. Among these patients, 101 had accompanying fibula fracture while 27 had intact fibula. Fracture healing times were significantly shorter in the latter group (p=0.001). However, there was no statistically significant difference between the groups in terms of fracture angulation except for valgus angulation. Smoking history and the presence of open or closed fracture did not have a significant impact on outcomes (p=0.249). Discussion: Intact fibula shortens the healing time after intramedullary nail fixation of tibia diaphysis fracture.

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“…Two biomechanical cadaveric studies have investigated the impact of additional fibular fixation. They found that fibular fixation only increased resistance to torsion forces, without adding significant coronal and sagittal planes stability [ 11 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

Risk factors for malunion of distal tibia fractures treated by intramedullary nailing

Daas,

Jlidi,

Baghdadi

et al. 2024

J Orthop Surg Res

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Background The treatment of distal tibia fractures (DTF) has historically been a difficult challenge for orthopedic surgeons because of the particular characteristics of this anatomical region. Intra medullary nailing (IMN) remains the best treatment option. However, achieving and maintaining perfect reduction and stable fixation with IMN can be technically challenging due to the large medullary cavity within a short distal fragment. The aim of our study is to determine the risk factors for malunion in DTF treated with IMN. Methods It is a retrospective study including DTF treated surgically by IMN in the Orthopedics and Trauma Department at a tertiary hospital over a period of 7 years. The quality of reduction was evaluated by radiological assessment of the antero-posterior (AP) and lateral views of the tibia and ankle at the last follow-up. Results Our series included 90 patients with an average age of 44.8 years. Sex-ratio was 2.6. Tobacco use was reported in 35.6% of the patients. Diabetes was present in 11.1% of the patients, and 12.2% of them had open fractures. According to the OTA/AO classification, the majority of injuries were classified as type A1 (76.7%). Fibula fractures were present in 86.7% of cases. The mean follow-up was 48 months. Malunion occurred in 13 cases. Based on the univariate analysis, smoking and dynamic fixation were significantly associated with malunion. In the multiple logistic regression analysis, dynamic fixation was found to be a significant factor that increased the risk of malunion by 7.5 times. Conclusion Neither patient demographics nor fracture characteristics were risk factors for malunion. Nevertheless, it should be noted that dynamic nailing must be avoided as it is associated with a higher risk of malunion. Furthermore, one to two medial to lateral distal locking screws provide sufficient stability without the need for additional fibular fixation. Trial registration Not applicable.

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Role of the fibula in the stability of diaphyseal tibial fractures fixed by intramedullary nailing

Cited by 9 publications

References 33 publications

Treatment of Long Bone Fractures in Children by Elastic Stable Intramedullary Nailing: Outcome and Challenges in a Unit with Restricted Technical Platform

Treatment of Long Bone Fractures in Children by Elastic Stable Intramedullary Nailing: Outcome and Challenges in a Unit with Restricted Technical Platform

Does fibula fracture have an impact on tibial healing?

Risk factors for malunion of distal tibia fractures treated by intramedullary nailing

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