Study of clinicoradiological and functional outcomes of intramedullary nailing in diaphyseal radius ulna fractures in adults

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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Suprapatellar versus infrapatellar approaches in the treatment of tibia intramedullary nailing: a retrospective cohort study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-019-2961-x ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 2

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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Unreamed Intramedullary Nailing with Oblique Proximal and Biplanar Distal Interlocking Screws for Proximal Third Tibial Fractures

Journal of Orthopaedic Surgery ◽

10.1177/230949900901700106 ◽

2009 ◽

Vol 17 (1) ◽

pp. 23-27 ◽

Cited By ~ 5

Author(s):

VK Singh ◽

Y Singh ◽

PK Singh ◽

RK Goyal ◽

H Chandra

Keyword(s):

Compartment Syndrome ◽

Intramedullary Nailing ◽

Functional Outcomes ◽

Knee Flexion ◽

Delayed Union ◽

Tibial Fractures ◽

Entry Point ◽

Implant Failure ◽

Distal Locking ◽

Distal Interlocking

Purpose. To assess the outcome of unreamed intramedullary nailing through the lateralised entry point using oblique proximal and biplanar distal interlocking screws. Methods. 15 men and 3 women aged 25 to 58 (mean, 37) years underwent unreamed intramedullary nailing with oblique proximal and biplanar distal interlocking screws for proximal third metaphyseal tibial fractures. The entry point was kept proximal to the tibial tuberosity and slightly lateral to midline. Proximal locking was at 45° to the coronal and sagittal planes. Biplanar distal locking was in the coronal and sagittal planes. Results. 16 patients had bone union within 20 (mean, 17; range, 14–27) weeks; 2 underwent dynamisation for delayed union. Three patients had valgus angulation of <5°; 2 had a loss of terminal knee flexion; 3 had a loss of ankle dorsiflexion; and 3 had shortening of >0.5 cm. Functional outcomes were excellent in 13, good in 4, and fair in one patient. No patient endured neurovascular injury, compartment syndrome or implant failure. Conclusion. Unreamed intramedullary nailing with oblique proximal and biplanar distal interlocking screws for proximal third tibial fractures was effective in preventing malalignment.

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Systematic review: Functional outcomes and complications of intramedullary nailing versus plate fixation for both-bone diaphyseal forearm fractures in children

Injury ◽

10.1016/j.injury.2014.04.020 ◽

2014 ◽

Vol 45 (8) ◽

pp. 1135-1143 ◽

Cited By ~ 26

Author(s):

Akash Patel ◽

Lily Li ◽

Amarjit Anand

Keyword(s):

Systematic Review ◽

Intramedullary Nailing ◽

Functional Outcomes ◽

Plate Fixation ◽

Forearm Fractures ◽

Fractures In Children

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Determine the Mean Duration of Union in Femoral Shaft Fracture in Children Treated with Elastic Intra-Medullary Nailing

10.53350/pjmhs211551338 ◽

2021 ◽

Vol 15 (5) ◽

pp. 1338-1340

Author(s):

M. S. Zardad ◽

M. Younas ◽

S. A. Shah ◽

I. Muhammad ◽

M. Ullah ◽

...

Keyword(s):

Intramedullary Nailing ◽

Functional Outcomes ◽

Femoral Shaft Fracture ◽

Femoral Shaft ◽

Shaft Fracture ◽

Femoral Shaft Fractures ◽

Non Union ◽

Shaft Fractures ◽

Fractures In Children ◽

Medullary Nailing

Objective: The aim of this study is to determine the functional outcomes and mean duration of union in femoral shaft fracture in children treated with elastic intra-medullary nailing. Study Design:Retrospective Place and Duration: Conducted at Orthopaedic Unit Ayub Medical Teaching Institute Abbottabad and District Headquarter Teaching Hospital Gomal Medical College Dera Ismail Khan for duration from May 2020 to January 2021 (09 months). Methods: Total sixty eight patients with age ranges between 5-12 years were presented in this study. Patients detailed demographics age, sex and BMI were calculated after taking informed written consent. Complete patients were treated with elastic intramedullary nailing. Radiological assessment was done. Mean union time and complications associated to procedure were examined. Functional outcomes were analyzed according to the Flyn’s criteria. Follow-up was taken at 8 months postoperatively. Complete data was analyzed by SPSS 22.0 version. Results: Out of 68 patients, there were 48 (68.6%) males and 20 (31.4%) females. Most of the patients 41 (60.35) were aged between 8-12 years and the rest 27 (39.65%) were between 5-8 years.34 (50%) fractures were caused because of road accidents, falling from height were 20 (29.41%), due to sports were 10 (14.70%) and 4 (5.9%) were due to simple fall. 32 (47.06%) patients had left side fracture and 36 (52.94%) had right side fracture. Mean union time among patients was 4.14±2.72 months and there was no any case of non union. According to Flyn’s criteria, 50 (73.53%) cases had excellent results, 14 (20.6%) patients had good and fair results were among 4 (5.9%) cases. Complications were observed bone stiffness, delayed union and varus deformity among all cases. Conclusion: We concluded in this study thatElastic intramedullary nailing for femoral shaft fractures in children is safe and effective treatment modality. Union of bone achieved all the patients and majority of patients had excellent functional outcomes. Keywords: Femoral shaft fractures, Children, Elastic intra-medullary nail

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Locked Intramedullary Nailing versus Dynamic Compression Plating for Humeral Shaft Fractures

Journal of Orthopaedic Surgery ◽

10.1177/230949900901700202 ◽

2009 ◽

Vol 17 (2) ◽

pp. 139-141 ◽

Cited By ~ 48

Author(s):

Amit B Putti ◽

Rajendra B Uppin ◽

Babu B Putti

Keyword(s):

Intramedullary Nailing ◽

Functional Outcomes ◽

Dynamic Compression ◽

Adhesive Capsulitis ◽

Humeral Shaft ◽

Complication Rates ◽

Humeral Shaft Fractures ◽

Shaft Fractures ◽

Compression Plating ◽

Dynamic Compression Plating

Purpose. To compare functional outcomes, union and complication rates in patients treated with locked intramedullary nailing or dynamic compression plating for humeral shaft fractures. Methods. 32 men and 2 women with humeral shaft fractures were randomised to undergo locked antegrade intramedullary nailing (IMN, n=16) or dynamic compression plating (DCP, n=18). Patients with pathological fractures, grade-III open fractures, neurovascular injury, or fractures for more than 2 weeks were excluded. Fractures were classified according to the AO classification system (one in A1, 6 in A2, 12 in A3, 6 in B1, and 9 in B2). 28 were injured in road traffic accidents. The functional outcome (according to the American Shoulder and Elbow Surgeons [ASES] score) and rates of union and complication of the 2 groups were compared. Results. All patients were followed up for a minimum of 24 months. In the respective IMN and DCP groups, the mean ASES scores were 45.2 and 45.1 (p=0.69), the complication rates were 50% and 17% (p=0.038), and the non-union rates were 0% and 6% (p=0.15). In the IMN group, 2 sustained iatrogenic fractures during nail insertion; 2 had transient radial nerve palsies; one underwent nail removal for shoulder impingement; and 3 had adhesive capsulitis. In the DCP group, one underwent re-operation for implant failure; one had a superficial infection; and one developed adhesive capsulitis. Conclusion. The complication rate was higher in the IMN group, whereas functional outcomes were good with both modalities.

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Functional outcomes and health-related quality of life after intramedullary nailing of tibia shaft fractures

Injury ◽

10.1016/j.injury.2009.07.019 ◽

2009 ◽

Vol 40 ◽

pp. S9 ◽

Cited By ~ 3

Author(s):

D. Stengel ◽

A. Ekkernkamp ◽

M. Wich

Keyword(s):

Quality Of Life ◽

Intramedullary Nailing ◽

Functional Outcomes ◽

Health Related Quality ◽

Shaft Fractures ◽

Tibia Shaft Fractures ◽

Related Quality ◽

Health Related ◽

Tibia Shaft

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A study of clinicoradiological and functional outcomes of intramedullary nailing in diaphyseal radius ulna fractures

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20194821 ◽

2019 ◽

Vol 5 (6) ◽

pp. 1150

Author(s):

Parag M. Tank ◽

Yash S. Shah ◽

Rutvik D. Dave ◽

Vijay J. Patel

Keyword(s):

Functional Outcome ◽

Intramedullary Nailing ◽

Functional Outcomes ◽

Bone Fractures ◽

Case Series ◽

Functional Results ◽

Dash Score ◽

Retrospective Case ◽

Non Union ◽

Case Series Study

Background: The aim of this study was to evaluate the results of intramedullary nailing in diaphyseal fractures of radius and ulna in age group of 10 to 49 years and to understand its clinicoradiological and functional results.Methods: This is a retrospective case series study of forearm bone fractures and the selected management for the same over a period of 3 years. We chose the cases in which intramedullary nailing was the treatment modality which were followed up over a period of minimum 6 months. Patients with galeazzi variety, monteggia variety, pathological fracture or non-union after previous surgery were excluded. The outcomes were then evaluated with disabilities of the arm, shoulder and hand (DASH) score, Green and O’Brien score, and Grace and Eversmann functional outcome score.Results: Of the 22 patients, 10 patients had excellent functional outcome according to Grace and Eversmann score, 7 patients had good outcome, 4 patients had acceptable while 1 was unacceptable. Green and O’Brien also had similar results, except that patients among fair category were 3 and poor category were 3. The mean DASH score was 16.2.Conclusions: This study shows that closed method for fixation by intramedullary nailing of both bone forearm fractures leads to excellent to good functional outcomes (according to DASH score, Green and O Brien, and Grace and Eversmann score) with less complications. In 6 months follow up x ray there is radiological union in all cases with no angulation, malunion or non-union.

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