Long-Term Follow-up of Tibial Shaft Fractures Treated With Intramedullary Nailing

2008 ◽  
Vol 22 (8) ◽  
pp. 525-529 ◽  
Author(s):  
Kelly A Lefaivre ◽  
Pierre Guy ◽  
Holman Chan ◽  
Piotr A Blachut
2019 ◽  
Author(s):  
Yiliang Cui ◽  
Xingyi Hua ◽  
Florian Schmidutz ◽  
Jian Zhou ◽  
Zongsheng Yin ◽  
...  

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.


2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Yiliang Cui ◽  
Xingyi Hua ◽  
Florian Schmidutz ◽  
Jian Zhou ◽  
Zongsheng Yin ◽  
...  

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.


2021 ◽  
Vol 12 (4) ◽  
pp. 2303-2307
Author(s):  
Nizam Ahmed ◽  
Madan Lal ◽  
Niaz Hussain Keerio ◽  
Ghazanfar Ali Shah ◽  
Aftab Alam Khanzada ◽  
...  

This Research aimed to see how well isolated closed tibial fractures retained their reduction after being immobilized in a cast. Medical data were gathered for all patients of identified solitary closed tibial shaft fractures treated non-surgically. Males were more typically impacted than females among the 32 individuals evaluated. The mean age was 27.68 years old (SD=7.06). Direct trauma with motorcycle was the most prevalent causes of injury. The average follow-up time for each patient was 9.1 months (SD=2.36). According to the AO/OTA classification, 34.4 % of the fractures are A1.1, 28.1% are A2.1, and 37.5 % are A3. The average time for all fractures to heal was 13.7 weeks (SD=3.24). In the 22nd week, there was one occurrence of delayed union. Shortening of bone was less than 1 cm in 93.75 % of patients and more than 1.5 cm in 6.25% of patients. In 2 (6.25%) of the patients, the anterior or posterior angulation was more than 10 degrees. Furthermore, even with uncomplicated tibial fractures, there appears to be a debate about therapy selection when considering long-term physical handicap and a longer follow-up time.


2019 ◽  
Author(s):  
Yiliang Cui ◽  
Xingyi Hua ◽  
Florian Schmidutz ◽  
Jian Zhou ◽  
Zongsheng Yin ◽  
...  

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 tibia IMN through a SP or IP approach (1/2014-11/2016). The clinical and functional outcomes of knee joint were assessed with the Hospital for Special Surgery (HSS) Knee Score. Further evaluation included the operation time, intraoperative blood loss. Results: A total of 50 patients/fractures (26 IP and 24 SP) with a follow-up for a minimum 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. Analysis of all the HSS components scores revealed no significant differences between them concerning the 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: The SP and IP approaches can get equivalent knee functional outcomes in the treatment of tibial shaft fracture concerning the overall HSS knee score. However, for the HSS component, the IP approach was superior to SP approach regarding the ROM.


2021 ◽  
Vol 10 (5) ◽  
pp. 995
Author(s):  
Marja Perhomaa ◽  
Tytti Pokka ◽  
Linda Korhonen ◽  
Antti Kyrö ◽  
Jaakko Niinimäki ◽  
...  

The preferred surgical fixation of forearm shaft fractures in children is Elastic Stable Intramedullary Nailing (ESIN). Due to known disadvantageous effects of metal implants, a new surgical method using biodegradable polylactide-co-glycolide (PLGA) intramedullary nails has been developed but its long-term outcomes are unclear. The aim of this study was to compare the long-term outcomes of Biodegradable Intramedullary Nailing (BIN) to ESIN and assess the biodegradation of the study implants via magnetic resonance imaging (MRI). The study population of the prospective, randomized trial consisted of paediatric patients whose forearm shaft fractures were treated with BIN (n = 19) or ESIN (n = 16). Forearm rotation at minimally four years’ follow-up was the main outcome. There was no clinically significant difference in the recovery of the patients treated with the BIN as compared to those treated with the ESIN. More than half of the implants (57.7%, n = 15/26) were completely degraded, and the rest were degraded almost completely. The PLGA intramedullary nails used in the treatment of forearm shaft fractures in this study resulted in good function and anatomy. No unexpected disadvantages were found in the degradation of the implants. However, two implant failures had occurred in three months postoperatively.


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