Tibial Shaft Fractures
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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 ◽  
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 ◽  
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.

Cesar Angel Pesciallo ◽  
Germán Garabano ◽  
Leonel Perez Alamino ◽  
Tamara Leonor Dainotto ◽  
Stefano Gaggiotti ◽  

2021 ◽  
Vol 22 (1) ◽  
Yanshi Liu ◽  
Feiyu Cai ◽  
Kai Liu ◽  
Xingpeng Zhang ◽  
Hong Li ◽  

Abstract Background The purpose of this study was to determine the differences in clinical outcomes, if any, between intraoperative acute correction and postoperative gradual correction for tibial shaft fractures with multiplanar posttraumatic deformities using the hexapod external fixator. Methods We retrospectively analyzed 58 consecutive patients with tibial shaft fractures treated by the hexapod external fixator at our institution from January 2015 to April 2019. Twenty-three patients (Group I) underwent intraoperative acute correction, from January 2015 to October 2016. Starting in November 2016, the other 35 patients (Group II) all underwent postoperative gradual correction. The demographic data, operation duration, original residual deformities before correction, residual deformities after correction, and external fixation time were collected and analyzed. The clinical outcomes were evaluated by the Johner-Wruhs criteria at the last clinical visit. Results All patients achieved complete bone union with a mean time of 28.7 ± 4.6 weeks (range 21 to 37 weeks) in Group I and 27.9 ± 4.8 weeks (range 19 to 38 weeks) in Group II (P > 0.05). The operation duration in Group I (88.9 ± 7.7 min) was longer than that in Group II (61.9 ± 8.4 min), and there was a statistically significant difference (P < 0.05). There were no statistically significant differences between the two groups in original residual deformities before correction and residual deformities after correction (P > 0.05). The rate of postoperative complication was similar between the two groups. There was no statistical significance in demographic data and clinical outcomes between the two groups (P > 0.05). Conclusions There is no difference in clinical outcomes between intraoperative acute correction and postoperative gradual correction for tibial shaft fractures with multiplanar posttraumatic deformities using the hexapod external fixator. Postoperative gradual correction may shorten the duration in the operation room and decrease the potential intraoperative risk.

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