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European Journal of Orthopaedic Surgery & Traumatology

Published in:

08-10-2022 | Original Article

The relevance of the number of distal locking planes and nail to canal ratio in bone healing after intramedullary nailing in tibial shaft fractures

Authors: Germán Garabano, Sebastian Pereira, Leonel Perez Alamino, Glenda Ernst, Cesar Angel Pesciallo, Fernando Bidolegui

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 5/2023

Abstract

Introduction

The objective of this retrospective study was to assess the effect of the nail to canal ratio and the number and configuration of distal locking screws in bone healing in tibial shaft fractures.

Methods

We analyzed 223 consecutive tibial shaft fractures treated with reamed intramedullary nailing between January 2014 and December 2020. We recorded and evaluated the nail to canal ratio (NCR) and the number and configuration of distal locking screws. Median NCR was 0.87 (IQR 0.82-0.94). Ten (4.48%) fractures were treated with one distal locking screw, 173 (77.57%) with two, and 40 (17.93%) with three. Uniplanar fixation was used in 63 (28.25%), biplanar in 150 (67.26%), and triplanar in 10 (4.48%) cases. Uni-, bi-, and multivariate analyses were performed to compare patients who achieved bone union with those who did not.

Results

Bone union was achieved in 195 (87.44%) patients. Uni- and bivariate analyses showed that bone union increased significantly with larger NCR (p = 0.0001) and a greater number of locking planes (p = 0.001) and distal screws (p = 0.046). NCR > 0.78 (OR 48.77 CI 95% 15.39–154.56; p = < 0.0001) and distal locking screw configuration (OR 2.91 CI 95% 1.12–9.91; p = 0.046) were identified as independent variables for union.

Conclusion

Our findings suggest that in tibial shaft fractures treated with intramedullary nailing, NCR should be equal to or greater than 0.79. Additionally, distal locking screws should be used with a biplanar or triplanar configuration.

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Title: The relevance of the number of distal locking planes and nail to canal ratio in bone healing after intramedullary nailing in tibial shaft fractures
Authors: Germán Garabano
Sebastian Pereira
Leonel Perez Alamino
Glenda Ernst
Cesar Angel Pesciallo
Fernando Bidolegui
Publication date: 08-10-2022
Publisher: Springer Paris
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 5/2023
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-022-03401-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The relevance of the number of distal locking planes and nail to canal ratio in bone healing after intramedullary nailing in tibial shaft fractures

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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