The functional results of tibial shaft fractures treated with intramedullary nail compressed by proximal tube

Abstract

Nailing of tibial shaft fractures is considered the gold standard surgical method by many surgeons. The aim of this retrospective study was to investigate and compare the clinical outcome of tibial shaft fractures treated with intramedullary nails compressed by proximal tube and conventional intramedullary interlocking nails. Fifty-seven patients with tibial shaft fractures, treated with intramedullary nails compressed by proximal tube (n = 32) and the conventional interlocking nails (n = 25), were reviewed. All fractures except for one were united without any additional surgical intervention in the proximal compression tube nail group, whereas in the conventional interlocking nail group, six patients needed dynamization surgery (p = 0.005) and three cases of nonunion were recorded. In the proximal compression tube nail group, faster union occurred in 20 ± 2 (16–24) weeks (mean ± SD; range) without failure of locking screws and proximal nail migration, whereas in the conventional interlocking nail group, union occurred in 22 ± 2.5 (17–27) weeks (p = 0.001) with two failures of locking screws and two proximal nail migration. The proximal compression tube nail system is safer than the conventional nailing methods for the treatment for transverse and oblique tibial shaft fractures with a less rate of nonunion, proximal locking screw failure and proximal nail migration.

Fınıte Element Analysis Of The Effect Of Intramedullary Naıl Compressıon Amount On Fracture Unıon In Dıstal Tıbıal Dıaphyseal Fractures

“…Intramedullary interlocking compression nails can reduce the length of the fracture union period in patients with tibial fracture. [9] In our study, the union period was much shorter in Groups 2 and 3 (compression) when compared with that of Group 1 (non-compression). No statistically significant difference was found between Groups 2 and 3 in terms of the length of the union period.…”

Comparison of non-compression and compression interlocking intramedullary nailing in rabbit femoral shaft osteotomy model

“…[21,22] The results of these studies showed that additional compression provides improved healing outcomes with less rate of non-union in transverse and oblique tibial shaft fractures. [21,22] The intended amount of compression can be achieved with ICN additive to the body weight in loaded state of walking. Active compression resists distraction forces in the unloaded state.…”

Evaluation of the treatment outcome of tibia shaft fracture by close reduction and internal fixation with interlocking intramedullary nail, Freetown, Sierra Leone, 2023

“…Tibia shaft fractures are major injuries and can result in severe permanent disability, such as mal-alignment and limb shortening, as well as amputation [2,3]. Based on the type of tibial fracture, whether closed or open, proximal to the knee joint or ankle joint, displaced or un-displaced, generally, infections, compartment syndrome, and non-union are other well-recognized complications of fractures of the tibia [2,4,5] The overall infection rate after surgical intervention of these injuries is about 1% -4% [6]. Deep infection rates range from 1% after surgical fi xation of closed low-energy fractures up to 30% in complex open tibia fractures [7,8].…”

“…It is generally held in place by screws [2]. Intramedullary interlocking nails are very commonly used in trauma practice for tibial fractures, especially in the treatment of closed mid-shaft and Gustilo 1 fractures of the tibial [4] Intramedullary nailing of the tibial delivers consistently good results in terms of fracture union and functional outcomes, minimal surgical dissection with appropriate preservation of blood supply to the fracture [3]. Recent data suggest that early internal fi xation of closed long bone fractures is associated with improved outcomes, early weight bearing, less hospital stay, and early return to daily normal activities [2,[9][10][11].…”