Intramedullary Nailing of Tibial Shaft Fractures Distal to Total Knee Arthroplasty

2014 ◽  
Vol 28 (12) ◽  
pp. e296-e300 ◽  
Author(s):  
Justin M. Haller ◽  
Erik N. Kubiak ◽  
Andre Spiguel ◽  
Michael J. Gardner ◽  
Daniel S. Horwitz
Keyword(s):  
Total Knee Arthroplasty ◽  
Intramedullary Nailing ◽  
Knee Arthroplasty ◽  
Tibial Shaft ◽  
Shaft Fractures ◽  
Total Knee ◽  
Tibial Shaft Fractures

scholarly journals Shaft Fractures in Patients Requiring Primary or Revision Total Knee Arthroplasty Can Be Successfully Treated with Long-Stemmed Implants without Additional Fixation

2021 ◽  
Vol 10 (21) ◽  
pp. 4926
Author(s):  
Dariusz Grzelecki ◽  
Dariusz Marczak ◽  
Kamil Kwolek ◽  
Piotr Dudek ◽  
Marcin Tyrakowski ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Complication Rate ◽  
Functional Outcomes ◽  
Bone Union ◽  
Tibial Shaft ◽  
Shaft Fractures ◽  
Total Knee ◽  
Tibial Shaft Fractures ◽  
Additional Fixation

The aim of this study was to evaluate the bone union, complication rate, clinical and functional outcomes of long-stemmed total knee arthroplasty (TKA) in patients with periprosthetic femoral or tibial shaft fractures and in patients with femoral or tibial shaft fractures with coexisting advanced knee osteoarthritis (OA). This retrospective study comprised 25 patients who underwent surgery due to tibial or femoral shaft fractures: (1) with coexisting severe knee OA or (2) with a periprosthetic fracture requiring implant exchange. In all cases, fracture stabilization was performed intramedullary with the use of long-stemmed implants without the use of additional fixation material (plates, screws, or cerclage). Bone union was achieved in 22/25 patients (88%). One patient required revision with additional plate stabilization due to non-union, and asymptomatic partial bone union was observed in two cases. The group with periprosthetic fractures demonstrated good clinical (mean 73.1 ± 13.3) and moderate functional (mean 59.2 ± 18.8) outcomes in the Knee Society Scoring system (KSS). In the group with shaft fracture and coexisting OA significantly higher clinical (excellent results, mean 84.1 ± 11; p = 0.03) and functional (good results, mean 76.2 ± 20.6; p = 0.04) results were noted. There were no statistically significant differences in terms of range of motion (ROM) or complication rate between these two groups. One-stage TKA with a long-stemmed implant without the use of additional fixation material is an effective method for the treatment of femoral or tibial shaft fractures in patients who require joint replacement. Despite being technically demanding, the approach yields bone union and moderate to excellent clinical and functional outcomes with a relatively low complication rate.

scholarly journals Elastic Stable Intramedullary Nailing for Treatment of Pediatric Tibial Fractures

2016 ◽  
Vol 4 (1) ◽  
pp. 11
Author(s):  
Sandeep Gurung ◽  
Dipendra KC ◽  
Roshni Khatri
Keyword(s):  
Intramedullary Nailing ◽  
Demographic Data ◽  
Elastic Stable Intramedullary Nailing ◽  
Tibial Shaft ◽  
Elastic Stable Intramedullary Nail ◽  
Shaft Fractures ◽  
Tibia Fractures ◽  
One Year ◽  
Skeletally Immature Patient ◽  
Tibial Shaft Fractures

Introduction: Tibia fractures in the skeletally immature patient can usually be treated with above knee cast or patellar tendon bearing cast. The purpose of our study was to evaluate epidemiology and outcome of Elastic stable intramedullary nailing fixation of pediatric tibial shaft fractures treated at our institution.   Methods: Over a period of one year, fifty pediatric patients of tibial shaft fractures, with average age of 9.68 yr (SD=2.37), were treated with elastic stable intramedullary nail. Demographic data, union and complication rate were evaluated.   Results: There were 36 closed and 14 open fractures. The average time to union was 11.6 weeks  (SD=2.65) for close and  14.3 weeks (SD=2.62) for open fracture. There were no instances of growth arrest, remanipulations, or refracture.   Conclusion: We conclude that flexible intramedullary fixation is an easy and effective method of management of both open and closed unstable fractures of the tibia in children.

scholarly journals Suprapatellar versus infrapatellar approaches in the treatment of tibia intramedullary nailing ： A retrospective cohort study

2019 ◽  
Author(s):  
Yiliang Cui ◽  
Xingyi Hua ◽  
Florian Schmidutz ◽  
Jian Zhou ◽  
Zongsheng Yin ◽  
...  
Keyword(s):  
Blood Loss ◽  
Intramedullary Nailing ◽  
Functional Outcomes ◽  
Operation Time ◽  
Tibial Shaft ◽  
Shaft Fractures ◽  
Significant Difference ◽  
Special Surgery ◽  
Tibial Shaft Fractures

Abstract Background: Tibial shaft fractures are routinely managed with intramedullary nailing (IMN). An increasingly accepted technique is the suprapatellar (SP) approach. The purpose of this study was to compare the clinical and functional outcomes of knee joint after tibia IMN through an suprapatellar (SP) or traditional infrapatellar (IP) approach. Methods: Retrospective analysis was performed in patients with tibial shaft fractures that were treated with IMN through a SP or IP approach between 01/01/2014 and 31/12/2016. The clinical and functional outcomes of the knee were assessed with the Hospital for Special Surgery (HSS) Knee Score. Secondary outcomes included the operation time and intraoperative blood loss. Results: A total of 50 patients/fractures (26 IP and 24 SP) with a minimum follow-up of 15 months were evaluated. All fractures were OTA 42. No significant differences were found between the two groups in age, gender, side of fractures, operation time, intra-operative blood loss, and follow-up time. No significant difference was seen in HSS score ( P = 0.62) between them. Sub analysis of all the HSS components scores revealed no significant differences between pain ( P = 0.57), the stand and walk ( P = 0.54), the need for walking stick ( P = 0.60) and extension lag ( P = 0.60). The other HSS components showed full scores (IP 10 vs. SP 10) in both approaches, including muscle force, flexion deformity and stability components. The range of motion (ROM) component score was superior in the IP group ( P = 0.04) suggesting a higher ROM. Conclusions: Both SP and IP approach results in equivalent overall HSS knee scores. However, for the HSS component, the IP approach was superior to SP approach regarding the ROM.

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