Tibial Shaft
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2021 ◽  
Vol 10 (21) ◽  
pp. 4926
Dariusz Grzelecki ◽  
Dariusz Marczak ◽  
Kamil Kwolek ◽  
Piotr Dudek ◽  
Marcin Tyrakowski ◽  

The aim of this study was to evaluate the bone union, complication rate, clinical and functional outcomes of long-stemmed total knee arthroplasty (TKA) in patients with periprosthetic femoral or tibial shaft fractures and in patients with femoral or tibial shaft fractures with coexisting advanced knee osteoarthritis (OA). This retrospective study comprised 25 patients who underwent surgery due to tibial or femoral shaft fractures: (1) with coexisting severe knee OA or (2) with a periprosthetic fracture requiring implant exchange. In all cases, fracture stabilization was performed intramedullary with the use of long-stemmed implants without the use of additional fixation material (plates, screws, or cerclage). Bone union was achieved in 22/25 patients (88%). One patient required revision with additional plate stabilization due to non-union, and asymptomatic partial bone union was observed in two cases. The group with periprosthetic fractures demonstrated good clinical (mean 73.1 ± 13.3) and moderate functional (mean 59.2 ± 18.8) outcomes in the Knee Society Scoring system (KSS). In the group with shaft fracture and coexisting OA significantly higher clinical (excellent results, mean 84.1 ± 11; p = 0.03) and functional (good results, mean 76.2 ± 20.6; p = 0.04) results were noted. There were no statistically significant differences in terms of range of motion (ROM) or complication rate between these two groups. One-stage TKA with a long-stemmed implant without the use of additional fixation material is an effective method for the treatment of femoral or tibial shaft fractures in patients who require joint replacement. Despite being technically demanding, the approach yields bone union and moderate to excellent clinical and functional outcomes with a relatively low complication rate.

2022 ◽  
Vol 91 ◽  
pp. 66-72
Inga Kröger ◽  
Janina Müßig ◽  
Andreas Brand ◽  
Robert Pätzold ◽  
Hannes Wackerle ◽  

2021 ◽  
Henry Knipe ◽  
Sean Carter

2021 ◽  
Vol 8 ◽  
Abhishek Garg ◽  
Ankur Sahu ◽  
Aditya Seth ◽  
Ipanshu Malik ◽  
Rahul Sharma

Introduction: The purpose of this study was to evaluate the functional outcomes of suprapatellar intramedullary nailing for the treatment of tibial shaft fractures.Material and Methods: The present retrospective study included 10 cases aged more than 20 years, who were operated for tibial shaft fractures over last 3 years with suprapatellar tibial nailing. Patients were retrospectively followed up with all their previous surgical records and radiographs.Results: The mean age was 41.57±16.51 with a range of 20-72 years. Mean operating time was 81±10.15 minutes. Mean blood loss was 110±20.5 ml. Mean time for union was 15.15±1.35 weeks. No deep infection was noted. 1 patient had anterior knee pain. The mean Lysholm knee score was 87.91 ± 5.75.Conclusion: The suprapatellar approach is good and safe technique for nailing in the tibial fractures.

Medicine ◽  
2021 ◽  
Vol 100 (40) ◽  
pp. e27429
Takashi Suzuki ◽  
Taketo Kurozumi ◽  
Yuhei Nakayama ◽  
Kentaro Matsui ◽  
Yoshinobu Watanabe ◽  

2021 ◽  
Vol 12 (4) ◽  
pp. 2303-2307
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.

2021 ◽  
chen shi ◽  
he shan hai ◽  
zhang xiao lei ◽  
xu chun cheng ◽  
yang jian cheng ◽  

Abstract Objective: To explore the clinical efficacy and safety of small incision open reduction and intramedullary nail internal fixation surgery in the treatment of simple tibial shaft fracture compared to the closed reduction surgery. Methods: A total of fifty patients with simple tibial shaft fractures admitted to our hospital were randomly and equally assigned into the observation group and the control group. Patients in the observation group received small incision open reduction surgery with intramedullary nail while patients in the control group received the closed reduction surgery. The clinical efficacy, prognosis as well as safety profile were compared between the two groups. Results: Our data indicated that the average bleeding volume of patients in the observation group was increased while the operation time was decreased compared to the control group. No significant difference of postoperative complications, fracture healing time, and Johner-Wruhs scores was identified between the two groups. Conclusion: The small incision open reduction surgery can significantly shorten the operation time while achieved a similar clinical efficacy compared to the closed reduction surgery in simple tibial shaft fracture.

2021 ◽  
Vol 37 (7) ◽  
Zhonglian Zhu ◽  
Zhaodong Wang ◽  
Pinghui Zhou ◽  
Xuyi Wang ◽  
Jianzhong Guan

Objectives: To compare clinical efficacies of suprapatellar and infrapatellar intramedullary nailing approaches in treating tibial shaft fractures. Methods: Patients (n=110) admitted with tibial shaft fractures in our hospital from January 2017 to June 2020, who underwent procedures with internal fixation intramedullary nails, were retrospectively divided into suprapatellar and infrapatellar approach groups (n=55 each) based on the surgical method used for fracture repair. The clinical and functional outcomes of the knee were assessed six months after the surgery Results: Six months after the operation, the pooled value for excellent and good efficacy rates in the suprapatellar approach group, as indicated by Hospital for Special Surgery (HSS) Knee scoring system, was 90.91%, which was significantly higher than that in the infrapatellar approach group (76.36%). The degree of pain (visual analogue scale (VAS) score) of the patients in the suprapatellar approach group was over 2-fold lower than in the infrapatellar approach group (P < 0.001).The Lysholm knee score, range of motion (ROM), SF-36p, and SF-36M scores in the suprapatellar approach group were significantly higher than those in the infrapatellar approach group (P < 0.001). Conclusion: Suprapatellar approach had significantly higher clinical efficiency than infrapatellar approach, and can significantly reduce the degree of pain, promote the recovery of patients with knee joint involvement, improve the physical and psychological well-being, reduce the number of cases of postoperative delayed healing. doi: https://doi.org/10.12669/pjms.37.7.4766 How to cite this:Zhu Z, Wang Z, Zhou P, Wang X, Guan J. Comparison of clinical efficacy of suprapatellar and infrapatellar intramedullary nailing in treating tibial shaft fractures. Pak J Med Sci. 2021;37(7):---------.  doi: https://doi.org/10.12669/pjms.37.7.4766 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

2021 ◽  
Vol 2 (10) ◽  
pp. 825-833
Hannah L. Dailey ◽  
Peter Schwarzenberg ◽  
Edmund B. Webb, III ◽  
Sinead A. M. Boran ◽  
Shane Guerin ◽  

Aims The study objective was to prospectively assess clinical outcomes for a pilot cohort of tibial shaft fractures treated with a new tibial nailing system that produces controlled axial interfragmentary micromotion. The hypothesis was that axial micromotion enhances fracture healing compared to static interlocking. Methods Patients were treated in a single level I trauma centre over a 2.5-year period. Group allocation was not randomized; both the micromotion nail and standard-of-care static locking nails (control group) were commercially available and selected at the discretion of the treating surgeons. Injury risk levels were quantified using the Nonunion Risk Determination (NURD) score. Radiological healing was assessed until 24 weeks or clinical union. Low-dose CT scans were acquired at 12 weeks and virtual mechanical testing was performed to objectively assess structural bone healing. Results A total of 37 micromotion patients and 46 control patients were evaluated. There were no significant differences between groups in terms of age, sex, the proportion of open fractures, or NURD score. There were no nonunions (0%) in the micromotion group versus five (11%) in the control group. The proportion of fractures united was significantly higher in the micromotion group compared to control at 12 weeks (54% vs 30% united; p = 0.043), 18 weeks (81% vs 59%; p = 0.034), and 24 weeks (97% vs 74%; p = 0.005). Structural bone healing scores as assessed by CT scans tended to be higher with micromotion compared to control and this difference reached significance in patients who had biological comorbidities such as smoking. Conclusion In this pilot study, micromotion fixation was associated with improved healing compared to standard tibial nailing. Further prospective clinical studies will be needed to assess the strength and generalizability of any potential benefits of micromotion fixation. Cite this article: Bone Jt Open 2021;2(10):825–833.

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