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Intramedullary tibial nailing in distal third tibial fractures: distal locking screws and fracture non-union

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Abstract

Distal third tibial fractures are prone to non-union following tibial nail insertion. The purpose of this study was to assess the union of distal third tibial fractures in patients who have undergone intra-medullary (IM) tibial nailing with one versus two distal locking screws. Sixty-five patients who had intramedullary tibial nail fixation were retrospectively analysed. Our results showed that 80% of non-unions in distal third fractures had only one distal locking screw compared to 20% who had two distal locking screws. This is statistically significant (p<0.01). We therefore conclude that two distal locking screws are essential for distal third fractures.

Résumé

Les fractures du tiers distal du tibia sont réputées entraîner des retards de consolidation après enclouage. Le propos de cette étude est d’étudier la consolidation de ce type de fracture chez les patients ayant bénéficié d’un enclouage centro médullaire avec une ou deux vis de verrouillage distal. 65 patients ont ainsi été analysés de manière rétrospective. Les résultats sont les suivants 80% des pseudarthroses avait une seule vis de verrouillage distal alors que seulement 20% des pseudarthroses sont survenues chez les patients ayant un verrouillage avec deux vis distales. Il existe une différence significative (p < 0.01) entre ces deux techniques, le verrouillage distal avec deux vis est essentiel dans ce type de fracture.

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Authors and Affiliations

  1. Trauma and Orthopaedics, The Royal London Hospital, London, UK

    Aso Mohammed

  2. Homerton Hospital, London, UK

    Ramaswamy Saravanan

  3. Trauma and Orthopaedics, Homerton Hospital, London, UK

    Jason Zammit

  4. Trauma and Orthopaedics, Oldchurch Hospital, London, UK

    Richard King

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  1. Aso Mohammed
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  2. Ramaswamy Saravanan
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  3. Jason Zammit
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  4. Richard King
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Correspondence to Aso Mohammed.

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Mohammed, A., Saravanan, R., Zammit, J. et al. Intramedullary tibial nailing in distal third tibial fractures: distal locking screws and fracture non-union. International Orthopaedics (SICO 32, 547–549 (2008). https://doi.org/10.1007/s00264-007-0356-3

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  • DOI: https://doi.org/10.1007/s00264-007-0356-3

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