The Results of Closed Intramedullary Nailing for Intra-articular Distal Tibial Fractures

Katsenis, D.; Begkas, Dimitris; Spiliopoulos, Giannis; Stamoulis, Dimitris; Pogiatzis, K.

doi:10.1097/bot.0b013e31829e7358

Cited by 13 publications

(23 citation statements)

References 32 publications

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“…During surgery, the guide wire must be carefully placed through the center of the coronal and sagittal planes of the ankle. [2] Fixation of the fibula in distal tibial fractures is also a controversial topic. Egol et al [16] found a late malalignment rate of 4% in distal tibial fractures treated with fibular fixation and of 13% in distal tibial fractures treated without fibular fixation.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] Intramedullary nailing and fixation with plate and screws are the most preferred methods of treatment for extra-articular distal tibia fractures. Both treatment methods have advantages and disadvantages.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] We primarily fixed intraarticular fragments with temporary percutaneous K-wires or screws to avoid these complications before intramedullary nailing. Intra-articular fragment displacement did not occur in any of our patients.…”

Section: Discussionmentioning

confidence: 99%

“…Clinically and radiologically, above five degrees of deformity in any plane was evaluated as malunion. [1,2] The number of screws applied to the distal tibial nail and the number of interfragmentary screws out of nail applied to the tibia were evaluated. Patients were clinically Is intramedullary nailing applicable for distal tibial fractures with ankle joint extension?…”

Section: Methodsmentioning

confidence: 99%

“…Each method has its own advantages and disadvantages. [1][2][3][4][5][6][7] Conservative methods of treatment are often not chosen today due to the requirement of long-term immobilization of the knee and ankle joints, the difficulty of these treatments, and the length of treatment time. [3,8] Although the fixing method with plate has the advantage of providing better mechanical support, there are publications reporting more complaints with this method, such as soft tissue problems and implant irritation.…”

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Is intramedullary nailing applicable for distal tibial fractures with ankle joint extension?

Beytemür¹

2016

Eklem Hastalik Cerrahisi

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ÖZ Amaç : We retrospectively evaluated 35 AO/OTA type 43C1 and C2 patients (26 males, 9 females; mean age 39.8±16.9 years; range 19 to 82 years) treated with intramedullary nailing. Two interfragmentary screws out of nail were applied in 10 patients (29%), while one interfragmentary screw out of nail was applied in 17 patients (49%). Intramedullary nailing was applied in eight patients (23%) without external screws. Fracture union, union time, alignment problems, and complications were evaluated. Clinical evaluation of patients was conducted using the Olerud and Molander score and by measuring the ankle joint range of motion. Results: Union was achieved in all 35 patients. Mean union time was 16.5±2.8 weeks (range 12 to 24 weeks) and mean Olerud and Molander score was 88±8.24. Varus deformity was detected in one patient, valgus deformity was detected in two patients, and rotation deformity was detected in one patient. Superficial infection was detected in three patients (9%). Deep infection was not detected in any patient. Conclusion: Intramedullary nailing is not contraindicated for simple intra-articular distal tibial fractures. In these fractures, intramedullary nailing performed in accordance with its technique, with an additional percutaneous screw if necessary, is a successful treatment option with high fracture union rates, high functional results, and low complication rates.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Is intramedullary nailing applicable for distal tibial fractures with ankle joint extension?

Beytemür¹

2016

Eklem Hastalik Cerrahisi

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Ankle Fractures, Including Avulsion Fractures

Eleftheriou

Calder

Kloen

et al. 2014

Sports and Traumatology

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Comparison of intramedullary nailing and minimal invasive plate osteosynthesis in the treatment of simple intra-articular fractures of the distal tibia (AO-OTA type 43 C1-C2)

Beytemür¹,

Barış²,

Albay³

et al. 2017

Acta Orthopaedica et Traumatologica Turcica

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ObjectiveThe aim of this study was to compare midterm functional and radiographic results of minimal invasive plate osteosynthesis (MIPO) with intramedullary nailing (IMN) of simple intra-articular distal tibial fractures (AO-OTA type 43 C1-C2).MethodsSeventy-three simple intra-articular distal tibial fracture patients were evaluated retrospectively. All were treated between 2009 and 2014. The average age of the patients was 40.3 years. Thirty-seven patients were treated with IMN and 36 patients were treated with MIPO. Fibular plate osteosynthesis was applied in 5 cases (13.5%) in the IMN group and in 23 patients (63.9%) in the MIPO group.ResultsFunctional results and complications of IMN and MIPO methods were assessed in 73 patients. The average union time was 16.4 ± 2.7 weeks in the IMN group and 15.2 ± 1.8 weeks in the MIPO group (p = 0.079). The average Olerud-Molander Ankle Score was 87.8 ± 8.1 in the IMN group and 81.5 ± 11.8 in the MIPO group (p = 0.013). Four patients in the IMN group experienced valgus malunion, while it was not observed in any patients in the MIPO group (p = 0.042). Recurvatum malunion was detected in 10 patients in the MIPO group and not seen in the IMN group (p = 0.001). Ankle dorsiflexion angle was 25.8 ± 4.5° in the IMN group and 33.3 ± 8.9° in the MIPO group (p = 0.000).ConclusionSimple intra-articular distal tibial fractures are successfully treated with IMN and MIPO. Prevalence of valgus malunion was higher in the IMN group and recurvatum was more prevalent in the MIPO group. MIPO is the first preference according to the literature; however, successful results have been obtained with IMN in this fracture pattern.Level of EvidenceLevel III, Therapeutic Study.

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The Results of Closed Intramedullary Nailing for Intra-articular Distal Tibial Fractures

Abstract: Therapeutic level IV. See instructions for authors for a complete description of levels of evidence.

Cited by 13 publications

References 32 publications

Is intramedullary nailing applicable for distal tibial fractures with ankle joint extension?

Is intramedullary nailing applicable for distal tibial fractures with ankle joint extension?

Ankle Fractures, Including Avulsion Fractures

Comparison of intramedullary nailing and minimal invasive plate osteosynthesis in the treatment of simple intra-articular fractures of the distal tibia (AO-OTA type 43 C1-C2)

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