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Distal articular involvement in tibial shaft fractures: an evaluation of 125 consecutive cases

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

To report the incidence and morphology of ipsilateral distal articular involvement (DAI) in a consecutive series of tibial shaft fractures.

Method

A retrospective review was performed on 115 patients who underwent intramedullary nailing for tibia shaft fractures. Ankle evaluations included preoperative radiographs and computed tomography (CT) scans in all patients.

Results

Thirty-two patients (27.8%) in our series presented with tibial shaft fractures associated with DAI. Tibial spiral fractures (42A1) were significantly related to DAI (RR: 1788). In 28 (87.5%; 28/32) articular fractures, posterior malleolus fractures (PMF) were present; 22 were isolated, and six (18.8%) occurred in combination with medial malleolus or anterolateral fractures. The remaining (12.5%; 4/32) were isolated medial malleolus fractures. Ten (31.2%; 10/32) articular fractures were occult on the radiographs and only detected on CT scan.

Conclusion

DAI is common in tibial shaft fractures. CT evaluation is mandatory due to the high number of occult fractures. Although isolated PMF is the most frequent pattern of DAI involvement, 31.3% of the cases exhibited different patterns.

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Availability of data and material

All data generated and analyzed during this study are included in this published article and are available from the corresponding author on reasonable request.

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Acknowledgements

Ted Miclau (M.D, PhD) for improving the native English language.

Funding

No funds, grants, or other support was received.

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Authors and Affiliations

  1. Orthopaedics and Trauma Surgery Department, Sirio Libanes Hospital, Campana 4658, C1419, Buenos Aires, Argentina

    Fernando Bidolegui & Sebastián Pereira

  2. Orthopaedics and Trauma Surgery Department, British Hospital of Buenos Aires, Perdriel 74, C1280 AEB, Buenos Aires, Argentina

    Germán Garabano, Joaquín Rodriguez & Cesar Angel Pesciallo

Authors
  1. Fernando Bidolegui
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  2. Sebastián Pereira
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  3. Germán Garabano
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  4. Joaquín Rodriguez
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  5. Cesar Angel Pesciallo
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Contributions

All authors contributed to the study´s conception and design. Material preparation, data collection, and analysis were performed by German Garabano, Sebastian Pereira, and Joaquín Rodriguez. The first draft of the manuscript was written by German Garabano, Cesar A. Pesciallo, Sebastian Pereira, and Fernando Bidolegui. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Fernando Bidolegui.

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Conflict of interest

The authors have no conflicts of interest to declare that are relevant to the content of this article.

Ethical approval

All procedures followed were in accordance with ethical standards of the British Hospital of Buenos Aires and Sirio Libanes Hospital committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.

Informed consent

Informed consent was obtained from all patients for being included in the study.

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Bidolegui, F., Pereira, S., Garabano, G. et al. Distal articular involvement in tibial shaft fractures: an evaluation of 125 consecutive cases. Eur J Orthop Surg Traumatol 33, 335–340 (2023). https://doi.org/10.1007/s00590-021-03188-6

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  • DOI: https://doi.org/10.1007/s00590-021-03188-6

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