Intramedullary Nailing of Tibial Shaft Fractures: Size Matters

Journal of Orthopaedic Trauma
Derek J DoneganSamir Mehta

Abstract

To determine optimal ratio of intramedullary nail diameter to tibial canal diameter that leads to reliable and timely healing in tibial shaft fractures. Retrospective case series. Level I trauma center. One hundred thirty-three fractures in 132 patients with tibial shaft fractures that underwent intramedullary nailing as definitive fixation were identified between June 2004 and July 2012 at our level I trauma center. Of these, 78 had serial radiographs out to 12 months that could be analyzed for radiographic healing with an average age of 37 years old (range 16-86 years). There were 52 males and 26 females. All patients underwent intramedullary nailing of the tibia with documentation of both the diameter of the nail and radiographic canal width at the isthmus to determine the nail to canal ratio. Patients were followed with serial radiographs for at least 12 months to determine time to healing as a function of nail to canal ratio. The senior author assessed healing at 3, 6, 9, and 12 months using RUST criteria. Patients with an intramedullary nail to canal diameter ratio of less than 0.8 or greater than 0.99 were 4.4 times more likely not to heal than patients with a ratio of between 0.8 and 0.99. The ideal intramedullary nail ...Continue Reading

References

May 1, 1995·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·E H SchemitschR M Harrington
May 31, 2001·Injury·C GaeblerV Vécsei
Apr 9, 2002·Clinical Orthopaedics and Related Research·P V GiannoudisR M Smith
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Jan 8, 2008·Journal of Orthopaedic Trauma·Peter AugatVolker Bühren
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Jan 5, 2013·Journal of Orthopaedic Trauma·Mohit BhandariUNKNOWN Assessment Group for Radiographic Evaluation and Evidence (AGREE) Study Group (AGREE Investigators Writing Committee)

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Citations

Feb 13, 2018·Journal of Orthopaedic Trauma·Andrew T ChenRaymond W Liu
Feb 6, 2018·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Christian David WeberUNKNOWN TraumaRegister DGU
Jul 2, 2019·Journal of Orthopaedic Trauma·Masato YuasaJonathan G Schoenecker
May 26, 2017·Journal of Orthopaedic Trauma·Sebastian J KoKelly A Lefaivre
May 15, 2019·Journal of Orthopaedic Trauma·Joseph BorrelliTracy Watson
Mar 25, 2021·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Narumi KawasakiUNKNOWN Hospitals of Trauma Research of Nagoya (TRON) group

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