AO Tibia Shaft Fractures, Closed Reduction and Reamed Intramedullary Nailing using the Expert Tibial Nail (ETN)

Author(s):  
Yves Acklin ◽  
Author(s):  
Ali Teoman EVREN ◽  
Yüksel Uğur YARADILMIŞ ◽  
Mustafa Caner OKKAOĞLU ◽  
Ahmet ATEŞ ◽  
İsmail DEMİRKALE ◽  
...  

2019 ◽  
Vol 30 (06) ◽  
pp. 483-489
Author(s):  
Antti Stenroos ◽  
Jani Puhakka ◽  
Yrjänä Nietosvaara ◽  
Jussi Kosola

AbstractTibia fractures are among the most common long-bone fractures in children. Despite this, there is no current consensus on the optimal treatment strategy for closed displaced tibia shaft fractures in the pediatric patient population. The aim of this study is to compare the reported complications and outcomes of reduction and cast immobilization versus flexible intramedullary nailing in the treatment of pediatric tibia shaft fractures. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement when conducting and reporting this prospectively registered systematic review. Eleven studies were included. Quality of the studies was assessed using the Coleman methodology score. Mantel–Haenszel cumulative odds ratios were used to compare the risk of complication between different methods of treatment. Eleven studies including 1,083 patients with diaphyseal fractures of the tibia met the inclusion criteria. The most common fracture type was simple 42-A (782; 91%). Majority (75%) of the patients were treated nonoperatively. The total complication rate was higher among operatively treated patients (24 vs. 9%; p < 0.05). Satisfactory fracture alignment had to be restored surgically in 5% of the primarily nonoperatively treated patients. The evidence levels of the included studies were II (1), III (2), and IV (7). Three-fourths of closed diaphyseal fractures of the tibia in children are still treated with reduction and cast immobilization. Flexible intramedullary nailing is associated with significantly higher complication rate than nonoperative treatment.


2020 ◽  
Author(s):  
Zhaofeng Jia ◽  
Shijin Wang ◽  
Tinghui Xiao ◽  
Wei Jiang ◽  
Tianjian Zhou ◽  
...  

Abstract Background: Closed reduction and locked intramedullary nailing has become a common surgical method in the treatment of femoral shaft fractures. Overlap and rotation displacements can usually be corrected through the use of an orthopaedic traction table. However, lateral displacement and angulation persist. Methods: In this paper, we describe a joystick that can be used in the closed reduction of a fracture. It can correct lateral displacement and angulation and has the advantage of multi-direction reduction. The device described in this paper includes two parallel horizontal joysticks, one vertical main joystick and four assistant rods. Moreover, there are many specific spacing holes in the two parallel horizontal joysticks and a groove structure in the vertical main joystick. When the main “H” joystick is pressed, it can adjust lateral displacements and angulation because of the lever principle. The distance between parallel horizontal joysticks and assistant rods can be adjusted to the fracture position and body mass index of different patients. Results: The study participants consisted of 11 males and 5 females with a mean age of 31.0 years. All participants had good closed reduction and achieved bony union without any complications such as infection, nerve injury, nonunion, malunion and limb length discrepancy. By using an “H” joystick, closed femoral shaft fracture reduction and locked intramedullary nailing becomes simpler and faster. Conclusion: Based on the use of this instrument, we can easily and conveniently obtain the correct reduction situation, which leads to better surgical results. This device can be applied in the reduction of clinical femoral fractures and gradually extended to the reduction of other fractures.


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