Abstract
Intramedullary nailing is the gold standard in the treatment of shaft tibial fractures. When in the past proximal tibial fractures had to be treated by nailing, it became difficult to control the large metaphyseal fragment, which led to a high risk of malalignment, iatrogenic fractures and anterior knee pain. The reduction forceps and “poller screw” techniques are useful to control the fracture site. In our experience, we started to practice tibial intramedullary nailing through a suprapatellar approach, in order to try a more proximal entry point and obtain a good alignment with the tibial axis. In our institute we also treated proximal tibial fractures involving the articular surface using nailing through a suprapatellar approach. The first step involved reduction of the articular fracture line using lag cannulated screws; after percutaneous osteosynthesis, we practiced an intramedullary nailing in the semi-extended knee position.
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Gli autori Giovanni Carlo Salvo, Salvatore Milazzo, Salvatore Bonfiglio e Gianfranco Longo dichiarano di non avere alcun conflitto di interesse.
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Salvo, G.C., Milazzo, S., Bonfiglio, S. et al. Il trattamento con chiodo delle fratture del terzo prossimale di tibia. LO SCALPELLO 29, 125–131 (2015). https://doi.org/10.1007/s11639-015-0119-7
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DOI: https://doi.org/10.1007/s11639-015-0119-7