Research Article
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Year 2020, Volume: 6 Issue: 4, 337 - 342, 04.07.2020
https://doi.org/10.18621/eurj.497382

Abstract

References

  • 1. Kojima K, Ferreira R. Tibial shaft fracture. Rev Bras Ortop 2011;46:130-5.
  • 2. Court-Brown CM, McBirnie J. The epidemiology of tibial fractures.J Bone Joint Surg Br 1995;77:417-21.
  • 3. Sarmiento A, Latta LL. 450 closed fractures of the distal third of the tibia treated with a functional brace. Clin Orthop Relat Res 2004;428:261-71.
  • 4. Guo JJ, Tang N, Yang HL, Tang TS. A prospective, randomised trial comparing closed intramedullary nailing with percutaneous plating in the treatment of distal metaphyseal fractures of the tibia. J Bone Joint Surg Br 2010;92:984-8.
  • 5. Vallier HA, Cureton BA, Patterson BM. Randomized, prospective comparison of plate versus intramedullary nail fixation for distal tibia shaft fractures. J Orthop Trauma 2011;25:736-41.
  • 6. Court-Brown CM, Christie J, McQueen MM. Closed intramedullary tibial nailing. Its use in closed and type I open fractures. J Bone Joint Surg Br 1990;72:605-11.
  • 7. Zelle BA, Bhandari M, Espiritu M, Koval KJ, Zlowodzki M; Evidence-Based Orthopaedic Trauma Working Group. Treatment of distal tibia fractures without articular involvement: a systematic review of 1125 fractures. J Orthop Trauma 2006;20:76-9.
  • 8. Teitz C, Carter Di Frankel V. Problems associated with tibial fractures with intact fibulae. J Bone Joint Surg 1980;62:770-6.
  • 9. Leow JM, Clement ND, Tawonsawatruk T, Simpson CJ, Simpson AHRW. The radiographic union scale in tibial (RUST) fractures. Bone Joint Res 2016;5:116-21.
  • 10. Alho A, Ekeland A, Strømsøe K, Follerås G, Thoresen BO. Locked intramedullary nailing for displaced tibial shaft fractures. J Bone Joint Surg Br 1990;72:805-9.
  • 11. Bhandari M, Guyatt GH, Swiontkowski MF, Tornetta P 3rd, Hanson B, Weaver B, et al. Surgeons’ preferences for the operative treatment of fractures of the tibial shaft. An international survey. J Bone Joint Surg Am 2001;83-A:1746-52.
  • 12. Russell TA. Fractures of the tibia and fibula. In: Rockwood CA, Green DP, Buckolz RW, Heckman JD, editors. Fractures in adults. 4th ed. Philadelphia: Lippincott; 1996: pp. 2139-57.
  • 13. Jorgensen TE. The influence of the intact fibula on the compression of a tibial fracture or pseudoarthrosis.Acta Orthop Scand 1974;45:119-29.
  • 14. Bone LB, Sucato D, Stegemann PM, Rohrbacher BJ. Displaced isolated fractures of the tibial shaft treated with either a cast or intramedullary nailing. An outcome analysis of matched pairs of patients. J Bone Joint Surg Am 1997;79:1336-41.
  • 15. Balaji SM, Chandra PM, Devadoss S, Devadoss A. The effect of intact fibula on functional outcome of reamed intramedullary interlocking nail in open and closed isolated tibial shaft fractures: a prospective study. Indian J Orthop 2016;50:201-5.
  • 16. Whelan DB, Bhandari M, McKee MD, Guyatt GH, Kreder HJ, Stephen D, et al. Interobserver and intraobserver variation in the assessment of the healing of tibial fractures after intramedullary fixation. J Bone Joint Surg Br 2002;84:15-8.
  • 17. Court-Brown CM. Reamed intramedullary tibial nailing: an overview and analysis of 1106 cases. J Orthop Trauma 2004;18:96-101.
  • 18. De Giacomo A, Tornetta P. Alignment after intramedullary nailing of distal tibia fractures without fibula fixation. J Orthop Trauma 2016;30:561-7.

Effect of anatomic fibula on tibia union and alignment after intramedullary nailing of tibia shaft fractures

Year 2020, Volume: 6 Issue: 4, 337 - 342, 04.07.2020
https://doi.org/10.18621/eurj.497382

Abstract

Objectives: The effect of an intact or fixated fibula on tibial union and alignment in tibial shaft fractures applied with intramedullary nailing is investigated.

Methods: A retrospective examination was made of 67 patients aged 19-85 years who were applied with intramedullary nailing for a tibial shaft fracture (AO-42) between January 2010 and December 2016. The 44 patients included in the study were separated into 2 groups as those with anatomic fibula (Group 1, n = 12) and those with a fibula fracture which is not fixated (Group 2, n = 32). The patients were evaluated in respect of bone union and malalignment from direct radiographs. Union was evaluated according to the RUST criteria, and the threshold for malalignment was taken as 5˚ in the coronal and sagittal planes.

Results: The patients comprised 24 males and 20 females (M/F: 6/5) with a mean age of 42.7 years (range, 19-76 years). Non-union was observed in 3/12 patients (25%) in Group 1, and in 2/32 (6.3%) patients in Group 2 at 6 months. Malalignment was observed in 1/12 (8.3%) patients in Group 1 (procurvatum) and in 7/32 (21.8%) patients in Group 2, of which 3 (9.3%) were varus, and 4 (12.5%) were valgus. The rate of malalignment was significantly lower in Group 1 than in Group 2.

Conclusions: The results demonstrated that bone union of a tibial shaft fracture is slower in patients with an anatomic fibula compared to those with non-anatomic fibula. Although the anatomic fibula slows the rate of union, it prevents malalignment.

References

  • 1. Kojima K, Ferreira R. Tibial shaft fracture. Rev Bras Ortop 2011;46:130-5.
  • 2. Court-Brown CM, McBirnie J. The epidemiology of tibial fractures.J Bone Joint Surg Br 1995;77:417-21.
  • 3. Sarmiento A, Latta LL. 450 closed fractures of the distal third of the tibia treated with a functional brace. Clin Orthop Relat Res 2004;428:261-71.
  • 4. Guo JJ, Tang N, Yang HL, Tang TS. A prospective, randomised trial comparing closed intramedullary nailing with percutaneous plating in the treatment of distal metaphyseal fractures of the tibia. J Bone Joint Surg Br 2010;92:984-8.
  • 5. Vallier HA, Cureton BA, Patterson BM. Randomized, prospective comparison of plate versus intramedullary nail fixation for distal tibia shaft fractures. J Orthop Trauma 2011;25:736-41.
  • 6. Court-Brown CM, Christie J, McQueen MM. Closed intramedullary tibial nailing. Its use in closed and type I open fractures. J Bone Joint Surg Br 1990;72:605-11.
  • 7. Zelle BA, Bhandari M, Espiritu M, Koval KJ, Zlowodzki M; Evidence-Based Orthopaedic Trauma Working Group. Treatment of distal tibia fractures without articular involvement: a systematic review of 1125 fractures. J Orthop Trauma 2006;20:76-9.
  • 8. Teitz C, Carter Di Frankel V. Problems associated with tibial fractures with intact fibulae. J Bone Joint Surg 1980;62:770-6.
  • 9. Leow JM, Clement ND, Tawonsawatruk T, Simpson CJ, Simpson AHRW. The radiographic union scale in tibial (RUST) fractures. Bone Joint Res 2016;5:116-21.
  • 10. Alho A, Ekeland A, Strømsøe K, Follerås G, Thoresen BO. Locked intramedullary nailing for displaced tibial shaft fractures. J Bone Joint Surg Br 1990;72:805-9.
  • 11. Bhandari M, Guyatt GH, Swiontkowski MF, Tornetta P 3rd, Hanson B, Weaver B, et al. Surgeons’ preferences for the operative treatment of fractures of the tibial shaft. An international survey. J Bone Joint Surg Am 2001;83-A:1746-52.
  • 12. Russell TA. Fractures of the tibia and fibula. In: Rockwood CA, Green DP, Buckolz RW, Heckman JD, editors. Fractures in adults. 4th ed. Philadelphia: Lippincott; 1996: pp. 2139-57.
  • 13. Jorgensen TE. The influence of the intact fibula on the compression of a tibial fracture or pseudoarthrosis.Acta Orthop Scand 1974;45:119-29.
  • 14. Bone LB, Sucato D, Stegemann PM, Rohrbacher BJ. Displaced isolated fractures of the tibial shaft treated with either a cast or intramedullary nailing. An outcome analysis of matched pairs of patients. J Bone Joint Surg Am 1997;79:1336-41.
  • 15. Balaji SM, Chandra PM, Devadoss S, Devadoss A. The effect of intact fibula on functional outcome of reamed intramedullary interlocking nail in open and closed isolated tibial shaft fractures: a prospective study. Indian J Orthop 2016;50:201-5.
  • 16. Whelan DB, Bhandari M, McKee MD, Guyatt GH, Kreder HJ, Stephen D, et al. Interobserver and intraobserver variation in the assessment of the healing of tibial fractures after intramedullary fixation. J Bone Joint Surg Br 2002;84:15-8.
  • 17. Court-Brown CM. Reamed intramedullary tibial nailing: an overview and analysis of 1106 cases. J Orthop Trauma 2004;18:96-101.
  • 18. De Giacomo A, Tornetta P. Alignment after intramedullary nailing of distal tibia fractures without fibula fixation. J Orthop Trauma 2016;30:561-7.
There are 18 citations in total.

Details

Primary Language English
Subjects Orthopaedics
Journal Section Original Articles
Authors

Ali Teoman Evren 0000-0002-1741-3894

Yüksel Uğur Yaradılmış 0000-0002-7606-5690

Mustafa Caner Okkaoğlu This is me 0000-0002-9149-1858

Ahmet Ateş This is me 0000-0002-7576-0026

İsmail Demirkale 0000-0001-7230-1599

Murat Altay This is me 0000-0002-1898-3733

Publication Date July 4, 2020
Submission Date December 14, 2018
Acceptance Date January 27, 2020
Published in Issue Year 2020 Volume: 6 Issue: 4

Cite

AMA Evren AT, Yaradılmış YU, Okkaoğlu MC, Ateş A, Demirkale İ, Altay M. Effect of anatomic fibula on tibia union and alignment after intramedullary nailing of tibia shaft fractures. Eur Res J. July 2020;6(4):337-342. doi:10.18621/eurj.497382

e-ISSN: 2149-3189 


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