Treatment of distal intraarticular tibial fractures: A biomechanical evaluation of intramedullary nailing vs. angle-stable plate osteosynthesis

Kühn, Sebastian; Greenfield, Julia; Arand, Charlotte; Jarmolaew, Andrey; Appelmann, Philipp; Mehler, Dorothea; Rommens, Pol Maria

doi:10.1016/s0020-1383(15)30026-7

Cited by 30 publications

(30 citation statements)

References 29 publications

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“…2 Biomechanically, an intramedullary implant has been shown to be superior in axial loading stress, whereas being equivocal under torsional loads compared with a medial plate construct, thus perhaps permitting earlier weight-bearing. 4 The use of an intramedullary implant is advised in patients with distal tibia injury patterns as they result in decreased soft tissue dissection, and possibly allow earlier weight-bearing. 4 The use of an intramedullary implant is advised in patients with distal tibia injury patterns as they result in decreased soft tissue dissection, and possibly allow earlier weight-bearing.…”

Section: The Selection Of the Appropriate Implant For Fracture Fixatimentioning

confidence: 99%

Intramedullary Nail Fixation of Distal Tibia Fractures: Tips and Tricks

Talerico

Ahn

2016

Journal of Orthopaedic Trauma

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The objective of this article is to highlight the salient points of preoperative planning, intraoperative considerations for fracture reduction methods, and implant fixation when treating distal diaphyseal or diametaphyseal tibia fractures with an intramedullary nail. Through review of the necessary preoperative considerations, techniques available to hold and maintain a reduction, and lastly how to maximize the selected implant of intramedullary nail, we hope to assist the treating surgeon in simplifying these sometimes complex fractures into manageable injuries that can be treated successfully with an intramedullary implant.

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Section: The Selection Of the Appropriate Implant For Fracture Fixatimentioning

confidence: 99%

Intramedullary Nail Fixation of Distal Tibia Fractures: Tips and Tricks

Talerico

Ahn

2016

Journal of Orthopaedic Trauma

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“…Our patient had malunited tibial fracture for 20 years and skin coverage over deformity site was adequate. Intramedullary nail helped in early weight bearing as it is load sharing device [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Total Knee Arthroplasty after Correction of Tibial Diaphyseal Nonunion with Clamshell Osteotomy

Desai

Sharma²,

Prakash³

2018

Case Reports in Orthopedics

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Total knee arthroplasty is mostly done to relieve pain and disability from a severe and degenerated knee. Deformities in the coronal and sagittal plane could be corrected with the help of cuts made in tibia and femur during total knee replacement as well as with ligament release. However, large deformities in the lower extremity particularly in the diaphysis region need correction prior to the total knee replacement. It helps to limit the amount of bone that will be cut and helps the ligament release. Several extra articular and intra-articular methods for the correction of diaphyseal deformity have been described. We present the case of clamshell osteotomy for the correction of diaphyseal deformity in the tibia and a total knee replacement after the osteotomy site healed.

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“…They found IMN to be significantly more durable with regard to axial loadings, while no significant difference was found with respect to torsional loading. 9 …”

Section: Discussionmentioning

confidence: 99%

“…Treatment options for distal tibial fractures remain quite controversial. 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 Intramedullary nailing, osteosynthesis with plates, and external fixation methods are used. Each method has its own advantages and disadvantages.…”

Section: Introductionmentioning

confidence: 99%

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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Treatment of distal intraarticular tibial fractures: A biomechanical evaluation of intramedullary nailing vs. angle-stable plate osteosynthesis

Cited by 30 publications

References 29 publications

Intramedullary Nail Fixation of Distal Tibia Fractures: Tips and Tricks

Intramedullary Nail Fixation of Distal Tibia Fractures: Tips and Tricks

Total Knee Arthroplasty after Correction of Tibial Diaphyseal Nonunion with Clamshell Osteotomy

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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