Virtual prototyping of a new intramedullary nail for tibial fractures

2012 ◽  
Vol 7 (3) ◽  
pp. 159-169 ◽  
Author(s):  
Tommaso Ingrassia ◽  
Antonio Mancuso
Keyword(s):  
Intramedullary Nail ◽  
Virtual Prototyping ◽  
Tibial Fractures

scholarly journals Operative Choice for Open Tibial Shaft Fracture in Children: A Comparative Study of External Fixator Vs. Elastic Stable Intramedullary Nail

2021 ◽  
Author(s):  
Pan Hong ◽  
Saroj Rai ◽  
Xin Tang ◽  
Ruikang Liu ◽  
Jin Li
Keyword(s):  
Clinical Outcomes ◽  
External Fixator ◽  
Intramedullary Nail ◽  
Shaft Fracture ◽  
Tibial Fractures ◽  
Tibial Shaft Fracture ◽  
Tibial Shaft ◽  
Elastic Stable Intramedullary Nail ◽  
Open Tibial Fractures ◽  
Significant Difference

Abstract IntroductionExternal fixator (EF) is a preferred choice for open tibial fractures, but pin tract infection (PTI) and refracture are common complications. Elastic stable intramedullary nail (ESIN) has been reported in the treatment for open tibial fractures. This study aims to compare the clinical outcomes of EF vs. ESIN in the treatment for open tibial shaft fracture in children retrospectively.Material and methodsPatients aged 5-11 years old with Gustilo-Anderson II and IIIA tibial shaft fracture treated at our institute from January 2008 to January 2018 were reviewed retrospectively and categorized into EF (n = 55) and ESIN (n = 37) group. Patients with pathological fracture, neuromuscular disorder, metabolic disease, previous tibial fracture or instrumentation, and polytrauma were excluded. Patients with follow up less than 24 months or incomplete medical records were also excluded. ResultsIn all, fifty-five patients (33 males, 22 females) were included in the EF group, whereas 37 patients (21 males, 16 females) were included in the ESIN group. There was no significant difference between the two groups concerning sex, age, body weight, duration from injury to surgery, Gustilo-Anderson (GA) classification, and concomitant injuries. There was no patient of nonunion and malunion in either group. The incidence of implant prominence was higher in the ESIN group (16%) than those in the EF group (0), P < 0.001. The angulation was higher in the EF group than ESIN group in coronal and sagittal plane, P < 0.001. The radiological union was faster in the ESIN group (7.0 ± 0.9, weeks) than those in the EF group (9.0 ± 2.2), P < 0.001. Limb length discrepancy (LLD) was significantly longer in the EF group (12.1 ± 4.4, mm) than those in the ESIN group (7.3 ± 4.3, mm), P < 0.001. ConclusionESIN is a viable option in selected patients of GA grade II and IIIA open tibial fractures with comparable clinical outcomes as external fixator, but with less complications including superficial infection, residual angulation and refracture after hardware removal.

scholarly journals Fixation of Distal Tibial Fractures by Intramedullary Nail with Multidirectional Distal Locking Screws

2019 ◽  
Vol 87 (September) ◽  
pp. 3435-3442
Author(s):  
MOHAMED E. TAHA, M.Sc.; ALI M. EMRAN, M.D. ◽  
KAMAL M. HAHEZ, M.D.; NABIL O. GHARBO, M.D.
Keyword(s):  
Intramedullary Nail ◽  
Tibial Fractures ◽  
Distal Tibial Fractures ◽  
Distal Locking ◽  
Locking Screws

Intramedullary nailing of extra-articular distal tibial fractures

2021 ◽  
Vol 103-B (2) ◽  
pp. 294-298
Author(s):  
Michael M. Hadeed ◽  
Hans Prakash ◽  
Seth R. Yarboro ◽  
David B. Weiss
Keyword(s):  
Intramedullary Nail ◽  
Sagittal Alignment ◽  
Weight Bearing ◽  
Biomechanical Model ◽  
Tibial Fractures ◽  
Fracture Model ◽  
Coronal Alignment ◽  
Oblique Fracture ◽  
Distal Locking ◽  
Fracture Patterns

Aims The aim of this study was to determine the immediate post-fixation stability of a distal tibial fracture fixed with an intramedullary nail using a biomechanical model. This was used as a surrogate for immediate weight-bearing postoperatively. The goal was to help inform postoperative protocols. Methods A biomechanical model of distal metaphyseal tibial fractures was created using a fourth-generation composite bone model. Three fracture patterns were tested: spiral, oblique, and multifragmented. Each fracture extended to within 4 cm to 5 cm of the plafond. The models were nearly-anatomically reduced and stabilized with an intramedullary nail and three distal locking screws. Cyclic loading was performed to simulate normal gait. Loading was completed in compression at 3,000 N at 1 Hz for a total of 70,000 cycles. Displacement (shortening, coronal and sagittal angulation) was measured at regular intervals. Results The spiral and oblique fracture patterns withstood simulated weight-bearing with minimal displacement. The multifragmented model had early implant failure with breaking of the distal locking screws. The spiral fracture model shortened by a mean of 0.3 mm (SD 0.2), and developed a mean coronal angulation of 2.0° (SD 1.9°) and a mean sagittal angulation of 1.2° (SD 1.1°). On average, 88% of the shortening, 74% of the change in coronal alignment, and 75% of the change in sagittal alignment occurred in the first 2,500 cycles. No late acceleration of displacement was noted. The oblique fracture model shortened by a mean of 0.2 mm (SD 0.1) and developed a mean coronal angulation of 2.4° (SD 1.6°) and a mean sagittal angulation of 2.6° (SD 1.4°). On average, 44% of the shortening, 39% of the change in coronal alignment, and 79% of the change in sagittal alignment occurred in the first 2,500 cycles. No late acceleration of displacement was noted. Conclusion For spiral and oblique fracture patterns, simulated weight-bearing resulted in a clinically acceptable degree of displacement. Most displacement occurred early in the test period, and the rate of displacement decreased over time. Based on this model, we offer evidence that early weight-bearing appears safe for well reduced oblique and spiral fractures, but not in multifragmented patterns that have poor bone contact. Cite this article: Bone Joint J 2021;103-B(2):294–298.

scholarly journals Intramedullary nail versus plate treatments for distal tibial fractures: A meta-analysis

2015 ◽  
Vol 16 ◽  
pp. 60-68 ◽  
Author(s):  
Jiwen Yu ◽  
Leiming Li ◽  
Tong Wang ◽  
Luxin Sheng ◽  
Yongfeng Huo ◽  
...  
Keyword(s):  
Intramedullary Nail ◽  
Meta Analysis ◽  
Tibial Fractures ◽  
Distal Tibial Fractures
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