Biomechanical comparison of distal locking screws for distal tibia fracture intramedullary nailing

Introduction: Tibia fractures are the most common long bone fractures encountered by the orthopedic surgeons and distal tibia fractures have the second highest incidence of all tibia fractures after the middle third of tibia the distal tibial fractures are unique and are considered as most challenging fractures to treat due to its proximity to the ankle joint and its superficial nature. The objective of this study is to compare two osteosynthesis systems developed for surgical treatment of distal tibia fractures: the intramedullary nailing and the MIPO technique. Methods: The study was conducted between Jan 2018 to Dec 2019. 30 patients with extraarticular distal tibia fracture treated with intramedullary nailing and MIPO technique were reviewed retrospectively and clinical outcome was evaluated according to American Orthopaedic Foot and Ankle Score. Results: 15 patients were treated with intramedullary nail and 15 with MIPO technique. Fibular fixation was done in cases where fibular fracture was at or below the level of tibial fractures. We found no difference in terms of time for fracture union, mal-union, non-union, duration of surgery and amount of blood loss. But there was significant difference in terms of infection and duration of hospital stay. Also weight bearing was possible much earlier in intramedullary group as compared to the MIPO group. Conclusion: Thus we conclude that intramedullary nailing is better choice of implant in patients with extra- articular distal tibia fractures and helps in early weight bearing and ambulation of patient with fewer complications. J Shaheed Suhrawardy Med Coll, December 2020, Vol.12(1); 33-37

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Treatment of distal tibia fractures: plating versus intramedullary nailing

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20163035 ◽

2016 ◽

Vol 2 (3) ◽

pp. 116

Author(s):

Yashavantha Kumar C. ◽

Shivaprasad M. S. ◽

Trilok V.

Keyword(s):

Intramedullary Nailing ◽

Average Duration ◽

Distal Tibia ◽

Tibia Fracture ◽

Complication Rates ◽

Care Hospital ◽

Distal Tibia Fracture ◽

Duration Of Surgery ◽

Tibia Fractures ◽

Distal Tibia Fractures

Background: Distal tibia shaft fractures pose significant challenge to treating surgeons. Giving more importance to anatomical reduction and ignoring often injured soft tissues has led to poor outcomes and high complication rates. Although multiple options are described to treat these fractures, there is no consensus on the best method of treatment. We hereby want to study the results of distal tibia fractures treated by expert tibia nailing and distal tibia plating.Methods: This study was undertaken in patients who were operated in between January 2012 to March 2015 at M S Ramaiah Teaching Hospital, which is a tertiary care hospital in Bangalore. Study included 52 patients with distal tibia fracture treated by surgery. All the fractures were closed distal diaphyseal fractures without articular involvement. Thirty two patients underwent expert tibia nailing whereas 20 patients were treated with open reduction and internal fixation with locking plates. Patients were followed up at 6 weeks, 3 months, 6 months and 1 year.Results: Fifty two patients included in study and they were divided into two groups as nailing group and plating group. Plating group included 20 patients whereas nailing group included 32 patients. The mode of injury was road traffic injury in 32 cases , followed by self-fall in 17 cases and sports related injury in 3 cases. Distal tibia fracture was associated with in 29 patients (87%) of nailing group whereas in 17 patients (80) of plating group. Average distance of fracture from pilon was 6 cm in nailing group and 3cm in plating group. The average duration of surgery in nailing was group was 88 minutes (range, 65-130 minutes) whereas average duration of surgery in plating group was group was 92 minutes (range, 70-130 minutes). The average time for union was 16 weeks for nailing group and for plating group it was 18 weeks. Conclusions: Both intramedullary nailing and plating are the optimal methods of treatment. Plating is preferred in cases where fracture is close to pilon whereas intramedullary nailing is preferred for fractures away from tibial pilon. There is no significant difference between union and complication rates.

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Salter-Harris Type II Distal Tibia Fracture

Orthopedics ◽

10.3928/0147-7447-20001101-20 ◽

2000 ◽

Vol 23 (11) ◽

pp. 1197-1198

Author(s):

Wade P McAlister ◽

Richard L Uhl

Keyword(s):

Distal Tibia ◽

Tibia Fracture ◽

Type Ii ◽

Distal Tibia Fracture ◽

Salter Harris

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Clinical Outcomes of Locking Compression Plate Fixation through Minimally Invasive Percutaneous Plate Osteosynthesis in the Treatment of Distal Tibia Fracture

Journal of the Korean Fracture Society ◽

10.12671/jkfs.2012.25.2.117 ◽

2012 ◽

Vol 25 (2) ◽

pp. 117 ◽

Cited By ~ 1

Author(s):

Jae-Sung Yoo ◽

Hyun-Woo Park

Keyword(s):

Minimally Invasive ◽

Clinical Outcomes ◽

Plate Osteosynthesis ◽

Plate Fixation ◽

Distal Tibia ◽

Locking Compression Plate ◽

Tibia Fracture ◽

Distal Tibia Fracture ◽

Compression Plate

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Intramedullary Nail for a Distal Tibia Fracture

Journal of Orthopaedic Trauma ◽

10.1097/bot.0000000000001837 ◽

2020 ◽

Vol 34 (2) ◽

pp. S37-S38

Author(s):

Nathaniel E. Schaffer ◽

Jenna L. Wilson ◽

Michael A. Yee ◽

Mark E. Hake

Keyword(s):

Intramedullary Nail ◽

Distal Tibia ◽

Tibia Fracture ◽

Distal Tibia Fracture

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Smoking Effects in a Distal Tibia Fracture Treated With External Fixation

Orthopaedic Nursing ◽

10.1097/nor.0000000000000301 ◽

2016 ◽

Vol 35 (6) ◽

pp. 426-428

Author(s):

Andrea Emilio Salvi ◽

Alexander Nikolaevich Chelnokov ◽

Simone Roda

Keyword(s):

External Fixation ◽

Distal Tibia ◽

Tibia Fracture ◽

Distal Tibia Fracture

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Ipsilateral Rupture of Quadriceps Tendon with Distal Tibia Fracture: A Case Report and Review of the Literature

Case Reports in Orthopedics ◽

10.1155/2017/5012948 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Samik Banerjee ◽

Timothy P. Dooley ◽

James R. Parkinson

Keyword(s):

English Literature ◽

Distal Tibia ◽

Tendon Repair ◽

Quadriceps Tendon ◽

Tibia Fracture ◽

Traumatic Rupture ◽

Distal Tibia Fracture ◽

Intramedullary Rodding ◽

High Index Of Suspicion ◽

Bone Tunnels

Traumatic rupture of the quadriceps tendon by itself is not an uncommon clinical condition. However, its association with concurrent ipsilateral closed distal tibia oblique fracture is exceedingly rare with only one previously reported case in English literature. The dual diagnosis of this atypical combination of injury may be masked by pain and immobilization of the more obvious fracture and may be missed, unless the treating physician maintains a high index of suspicion. Suprapatellar knee pain with or without a palpable gap in the quadriceps tendon and inability to straight leg raise in the setting of a distal tibia fracture should raise concern, but if initial treatment employs a long-leg splint the knee symptoms may be muted. In this report, we describe this unusual combination of injury in a 67-year-old male patient who sustained a trivial twisting injury to the leg. The aim of this report is to raise awareness and emphasize the importance of thorough and repeated clinical examinations in the presence of distracting injuries. Despite the complexity of the problem, standard techniques for quadriceps tendon repair using transpatellar bone tunnels following locked intramedullary rodding of the tibia fracture may lead to optimal outcomes.

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