Use of a Novel Tibial Traction Triangle for Intramedullary Nailing of Tibia Fractures

Abstract

Summary: Malalignment after intramedullary nailing of proximal and distal tibia fractures remains a significant problem. We describe the use of a novel device to ease treatment of tibia fractures that undergo intramedullary nailing. The tibial traction triangle is simple and easy to use and allows for better reductions, leading to lower rates of malalignment. A prospective series of 11 patients is presented.

A Novel Reduction Support Frame for Management of Unstable Tibial Fractures with Intramedullary Nail: Preliminary report

“…Achieving an accurate intraoperative reduction and maintenance of reduction is essential for management of UTF with intramedullary nailing. Original manual traction technique for nail insertion was described by McKee et al[ 13 ] The development of alternative reduction techniques such as pin-assisted traction table,[ 12 ] fixator-assisted traction,[ 19 ] temporary distractors,[ 11 , 20 , 21 ] and triangle device[ 22 ] was required by both practical and theoretical disadvantages of standard positioning and manual traction on operating table for the performance of intramedullary nailing of the UTF. [ 20 ] In the present study, we demonstrated that the frame constructed by re-used external fixator bars and clamps (TORS frame) has similar results compared to manual traction technique in terms of deformity correction.…”

“…Its’ knee flexion limit is about 70–90°. [ 22 ] However, intraoperatively the TORS frame can be adjusted to the individual length of patients’ tibia with any limitation by simply loosing a few numbers of nuts. It allows for knee flexion of about 125° (which is theoretically suggested) when required during the reduction, rimerization, and nailing.…”