Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
International Orthopaedics
Published in: International Orthopaedics 5/2007

01-10-2007 | Original Paper

Treatment of distal tibial fractures: plate versus nail

A retrospective outcome analysis of matched pairs of patients

Authors: Kasper W. Janssen, Jan Biert, Albert van Kampen

Published in: International Orthopaedics | Issue 5/2007

Login to get access

Abstract

A study of 24 patients who sustained an extra-articular fracture of the distal third of the tibial shaft was performed to determine the effect of the type of treatment, open reduction and internal fixation (ORIF) or closed reduction and intramedullary (IM) nailing, on the occurrence of malalignment. All patients were treated in our clinic between 1993 and 2001 for a fracture in the distal third of the tibia. Twelve patients treated with ORIF were matched to 12 patients treated with IM nailing, with regard to gender, age decade, and the AO classification of the fracture. The group treated with IM nailing was assessed after a mean 6.0 years versus ORIF after a mean of 4.5 years. Two patients treated with ORIF versus six patients treated with IM nailing had a malalignment of the tibia. Furthermore, we found no difference with regard to time to union, non-union, hardware failure or deep infections between ORIF and IM nailing. Our results suggest that control of alignment is difficult with IM nailing of distal tibial fractures. For optimal alignment we advise considering the use of ORIF for closed and type I open extra-articular fractures in the distal third of the tibia.
Literature
1.
Bone LB, Sucato D, Stegemann PM et al (1997) Displaced isolated fractures of the tibial shaft treated with either a cast or intramedullary nailing. J Bone Joint Surg Am 79:1336–1341PubMed
2.
Court-Brown CM, Gustilo T, Shaw AD (1997) Knee pain after intramedullary tibial nailing: its incidence, etiology, and outcome. J Orthop Trauma 11:103–105PubMedCrossRef
3.
Duda GN, Mandruzzato F, Heller M et al (2001) Mechanical boundary conditions of fracture healing: borderline indications in the treatment of unreamed tibial nailing. J Biomech 34:639–650PubMedCrossRef
4.
Duda GN, Mandruzzato F, Heller M et al (2003) Mechanical borderline indications in the treatment of unreamed tibial nailing. Unfallchirurg 106(8):683–689PubMedCrossRef
5.
Hooper GJ, Keddell RG, Penny ID (1991) Conservative management or closed nailing for tibial shaft fractures. A randomized prospective trial. J Bone Joint Surg Br 73(1):83–85PubMed
6.
Im GI, Tae SK (2005) Distal metaphyseal fractures of tibia: a prospective randomized trial of closed reduction and intramedullary nail versus open reduction and plate and screws fixation. J Trauma 59(5):1219–1223PubMed
7.
Insall JN, Dorr LD, Scott RD et al (1989) Rationale of the Knee Society clinical rating system. Clin Orthop 248:13–14PubMed
8.
Jaarsma RL, Bruggeman AW, Pakvis DF et al (2004) Computed tomography determined femoral torsion is not accurate. Arch Orthop Trauma Surg 124(8):552–554PubMedCrossRef
9.
Kahn KM, Beals RK (2002) Malrotation after locked intramedullary tibial nailing: three case reports and review of the literature. J Trauma 53(3):549–552PubMedCrossRef
10.
Karladani AH, Granhed H, Edshage B et al (2000) Displaced tibial shaft fractures. A prospective randomized study of closed intramedullary nailing versus cast treatment in 53 patients. Acta Orthop Scand 71(2):160–167PubMedCrossRef
11.
Krettek C, Stephan C, Schandelmaier P et al (1999) The use of Poller screws as blocking screws in stabilising tibial fractures treated with small diameter intramedullary nails. J Bone Joint Surg Br 81:963–968PubMedCrossRef
12.
Megas P, Zouboulis P, Papadopoulos AX, Karageorgos A, Lambiris E (2003) Distal tibial fractures and non-unions treated with shortened intramedullary nail. Int Orthop 27(6):348–351PubMedCrossRef
13.
Milner SA (1997) A more accurate method of measurement of angulation after fractures of the tibia. J Bone Joint Surg Br 79:972–974PubMedCrossRef
14.
Nork SE, Schwartz AK, Agel J, Holt SK, Schrick JL, Winquist RA (2005) Intramedullary nailing of distal metaphyseal tibial fractures. J Bone Joint Surg Am 87(6):1213–1221PubMedCrossRef
15.
Puno RM, Vaughan JJ, Stetten ML et al (1991) Long-term effects of tibial angular malunion on the knee and ankle joints. J Orthop Trauma 3:247–254CrossRef
16.
Van der Schoot DK, den Outer AJ, Bode PJ et al (1996) Degenerative changes at the knee and ankle related to malunion of tibial fractures. 15-year follow-up of 88 patients. J Bone Joint Surg Br 78:722–725PubMed
17.
Wissing H, Buddenbrock B (1993) Determining rotational errors of the femur by axial computerized tomography in comparison with clinical and conventional radiologic determination. Unfallchirurgie 19(3):145–157PubMedCrossRef
Metadata
Title
Treatment of distal tibial fractures: plate versus nail
A retrospective outcome analysis of matched pairs of patients
Authors
Kasper W. Janssen
Jan Biert
Albert van Kampen
Publication date
01-10-2007
Publisher
Springer-Verlag
Published in
International Orthopaedics / Issue 5/2007
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-006-0237-1

Other articles of this Issue 5/2007

International Orthopaedics 5/2007 Go to the issue

Original Paper

Tension-band wiring of transverse fractures of patella. The effect of site of wire twists and orientation of stainless steel wire loop: a biomechanical investigation

Original Paper

The treatment for multilevel noncontiguous spinal fractures

Original Paper

Facet joint violation during pedicle screw insertion: a cadaveric study of the adult lumbosacral spine comparing the two pedicle screw insertion techniques

Original Paper

Incidence of hip fracture in southeastern Norway

Original Paper

Surgical treatment of undisplaced femoral neck fractures in the elderly

Original Paper

Kinematic study following double-bundle, anterior cruciate ligament reconstruction