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European Journal of Trauma and Emergency Surgery

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Open Access 03-12-2021 | Tibia Fracture | Original Article

Retrograde tibial nailing of far distal tibia fractures: a biomechanical evaluation of double- versus triple-distal interlocking

Authors: Julia Greenfield, Philipp Appelmann, Felix Wunderlich, Dorothea Mehler, Pol Maria Rommens, Sebastian Kuhn

Published in: European Journal of Trauma and Emergency Surgery | Issue 5/2022

Abstract

Objectives

Retrograde tibial nailing using the Distal Tibia Nail (DTN) is a novel surgical option in the treatment of distal tibial fracture. Its unique retrograde insertion increases the range of surgical options in far distal fractures of the tibia beyond the use of plating. The aim of this study was to assess the feasibility of the DTN for far distal tibia fractures where only double rather than triple-distal locking is possible due to fracture localisation and morphology.

Methods

Six Sawbones^® were instrumented with a DTN and an AO/OTA 43-A3 fracture simulated. Samples were tested in two configurations: first with distal triple locking, second with double locking by removing one distal screw. Samples were subjected to compressive (350 N, 600 N) and torsional (± 8 Nm) loads. Stiffness construct and interfragmentary movement were quantified and compared between double and triple-locking configurations.

Results

The removal of one distal screw resulted in a 60–70% preservation of compressive stiffness, and 90% preservation of torsional stiffness for double locking compared to triple locking. Interfragmentary movement remained minimal for both compressive and torsional loading.

Conclusions

The DTN with a distal double locking can, therefore, be considered for far distal tibia fractures where nailing would be preferred over plating.

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Title: Retrograde tibial nailing of far distal tibia fractures: a biomechanical evaluation of double- versus triple-distal interlocking
Authors: Julia Greenfield
Philipp Appelmann
Felix Wunderlich
Dorothea Mehler
Pol Maria Rommens
Sebastian Kuhn
Publication date: 03-12-2021
Publisher: Springer Berlin Heidelberg
Keywords: Tibia Fracture
Distal Tibial Fracture
Published in: European Journal of Trauma and Emergency Surgery / Issue 5/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-021-01843-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Retrograde tibial nailing of far distal tibia fractures: a biomechanical evaluation of double- versus triple-distal interlocking

Abstract

Objectives

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

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