Can isolated tibia intramedullary interlocking nailing in fracture distal 1/3rd both bone leg prevent fracture malalignment: will concurrent fibula fixation help?

Background: Different stand point prevails till date concerning fibular osteosynthesis in distal third both bone fracture fixation. This study was done to assess the post op alignment of distal third both bones fracture without fixing Fibula.Methods: A total of 30 patients who had distal 1/3rd extra articular tibia and fibula fractures were included in the study from July 2016 to April 2019. Tibial nailing was done in all cases with care is taken particularly to prevent malalingment of distal fragment. Radiological malalignment were assessed post operatively.Results: Of 30 patients, 5 patients had excellent results and 21 patients had good results, only 4 patients had fair results with valgus and varus malalignment, however these patients did not have any clinical problems associated with these malalignment at one year follow up. No patients had poor results. Valgus tibial malalignment is observed more frequently when fibular fracture is at proximal level.Conclusions: The level of Fibular fracture is important to determine when the fixation of this bone is indicated. Fixing ipsilateral tibial fracture with intramedullary interlocking (IMIL) nailing without fibular synthesis produce no gross change in alignment provided adequate care is taken for intra operative centering of the nail in both AP and lateral views.

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Tibial nailing using a suprapatellar rather than an infrapatellar approach significantly reduces anterior knee pain postoperatively: a multicentre clinical trial

The Bone & Joint Journal ◽

10.1302/0301-620x.101b9.bjj-2018-1115.r2 ◽

2019 ◽

Vol 101-B (9) ◽

pp. 1138-1143 ◽

Cited By ~ 8

Author(s):

D. R. W. MacDonald ◽

P. Caba-Doussoux ◽

C. A. Carnegie ◽

I. Escriba ◽

D. P. Forward ◽

...

Keyword(s):

Knee Pain ◽

Anterior Knee Pain ◽

Tibial Fracture ◽

Patient Reported Outcome ◽

Surgical Approaches ◽

Patient Reported ◽

Suprapatellar Approach ◽

One Year ◽

Anterior Knee

Aims The aim of this study was to compare the incidence of anterior knee pain after antegrade tibial nailing using suprapatellar and infrapatellar surgical approaches Patients and Methods A total of 95 patients with a tibial fracture requiring an intramedullary nail were randomized to treatment using a supra- or infrapatellar approach. Anterior knee pain was assessed at four and six months, and one year postoperatively, using the Aberdeen Weightbearing Test – Knee (AWT-K) score and a visual analogue scale (VAS) score for pain. The AWT-K is an objective patient-reported outcome measure that uses weight transmitted through the knee when kneeling as a surrogate for anterior knee pain. Results A total of 53 patients were randomized to a suprapatellar approach and 42 to an infrapatellar approach. AWT-K results showed a greater mean proportion of weight transmitted through the injured leg compared with the uninjured leg when kneeling in the suprapatellar group compared with the infrapatellar group at all timepoints at all follow-up visits. This reached significance at four months for all timepoints except 30 seconds. It also reached significance at six months at 0 seconds, and for one year at 60 seconds. Conclusion The suprapatellar surgical approach for antegrade tibial nailing is associated with less anterior knee pain postoperatively compared with the infrapatellar approach Cite this article: Bone Joint J 2019;101-B:1138–1143

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Magnesium-Based Absorbable Metal Screws for Intra-Articular Fracture Fixation

Case Reports in Orthopedics ◽

10.1155/2016/9673174 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4 ◽

Cited By ~ 9

Author(s):

Roland Biber ◽

Johannes Pauser ◽

Markus Geßlein ◽

Hermann Josef Bail

Keyword(s):

Case Report ◽

Magnesium Alloy ◽

Fracture Fixation ◽

Clinical Course ◽

Radial Head Prosthesis ◽

Osteochondral Fracture ◽

Articular Fracture ◽

One Year ◽

Biodegradable Magnesium

MAGNEZIX® (Syntellix AG, Hanover, Germany) is a biodegradable magnesium-based alloy (MgYREZr) which is currently used to manufacture bioabsorbable compression screws. To date, there are very few studies reporting on a limited number of elective foot surgeries using this innovative implant. This case report describes the application of this screw for osteochondral fracture fixation at the humeral capitulum next to a loose radial head prosthesis, which was revised at the same time. The clinical course was uneventful. Degradation of the magnesium alloy did not interfere with fracture healing. Showing an excellent clinical result and free range-of-motion, the contour of the implant was still visible in a one-year follow-up.

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Trampoline-related fractures of the proximal tibia in children

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02707-9 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Changhoon Jeong ◽

Sang Uk Lee ◽

Hyun Gyun Kim ◽

Sun Young Joo

Keyword(s):

Young Children ◽

Tilt Angle ◽

Tibial Fracture ◽

Valgus Deformity ◽

Limb Length ◽

Common Mechanism ◽

Angular Deformity ◽

Proximal Tibial Fracture ◽

One Year

Abstract Background Trampoline-related fractures of the proximal tibial metaphysis are common in children and have been linked to subsequent valgus deformity of the tibia. The purpose of this study was to investigate the characteristics of trampoline-related proximal tibial fractures in young children. Methods We evaluated 40 patients with proximal tibial fracture after trampolining between 2013 and 2019. The median duration of follow-up was 18 months. Standing long leg radiographs were obtained at the last follow-up to evaluate angular deformity and limb length inequality in the patients. The measurements recorded include the lower limb length, mechanical lateral distal femoral angle (mLDFA), medial proximal tibial angle (MPTA), mechanical axis deviation (MAD), and anatomical tibio-femoral angle (aTFA). The anterior tilt angle (ATA) was measured using a lateral radiograph of the tibia. Results The median age at injury was 40.0 months. Using trampoline with a heavier person was the most common mechanism of injury. aTFA and MAD were found to be increased towards the valgus at the last follow-up in our patient; however, the increase was not statistically significant (p = 0.692 and p = 0.973, respectively). The anterior tilt angle was increased in the injured leg at the last follow-up. But the change was not statistically significant (p = 0.09). Conclusions Using trampoline with a heavier person carries the risk of trampoline-related proximal tibial fracture in young children. We did not find a significant change in limb alignment at a minimum of one year of follow-up.

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