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Tibial shaft fractures treated with intramedullary nailing and reduction device assistance

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Abstract

Purpose

This study aimed to assess the outcomes of a newly invented reduction device on assisting reduction of intramedullary nailing (IMN) in the treatment of tibial shaft fractures.

Methods

From January 2015 to December 2018, data of patients with tibial shaft fractures treated with IMN were reviewed. In total, 42 patients underwent treatment with the new reduction device (group A) and 56 underwent treatment using a traditional reduction technique (group B). Data related to the closed reduction rate, surgical time, blood loss, number of fluoroscopies, number of surgeons, and number of complications were also reviewed. Fracture healing was assessed using radiographs at each follow-up, and the functional outcome (AOFAS score) was evaluated at the final follow-up.

Results

The two treatment groups were evenly matched with respect to age, sex, fracture grade, and time to surgery. The average surgical time, blood loss, number of fluoroscopies, and number of surgeons in group A were all lesser than those in group B (P < 0.05). The closed reduction rate in group A was higher than those in group B (P < 0.05). The fracture healing time, AOFAS score, and complication rate were not significantly different (P > 0.05) between the two groups.

Conclusion

The new reduction device could effectively achieve and maintain the reduction of tibia shaft fractures in a minimally invasive fashion.

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Data availability

All data analysed in this study has been provided in the manuscript.

References

  1. Cruz AI Jr, Raducha JE, Swarup I, Schachne JM, Fabricant PD (2019) Evidence-based update on the surgical treatment of pediatric tibial shaft fractures. Curr Opin Pediatr 31:92–102

    Article  Google Scholar 

  2. Thompson J H, Jahangir A (2020) Tibia fractures overview. In: StatPearls. Treasure Island (FL),

  3. Wang B, Zhao Y, Wang Q et al (2019) Minimally invasive percutaneous plate osteosynthesis versus intramedullary nail fixation for distal tibial fractures: a systematic review and meta-analysis. J Orthop Surg Res 14:456

    Article  CAS  Google Scholar 

  4. Beytemur O, Baris A, Albay C, Yuksel S, Caglar S, Alagoz E (2017) Comparison of intramedullary nailing and minimal invasive plate osteosynthesis in the treatment of simple intra-articular fractures of the distal tibia (AO-OTA type 43 C1-C2). Acta Orthop Traumatol Turc 51:12–16

    Article  Google Scholar 

  5. Tas DB, Smeeing DPJ, Emmink BL, Govaert GAM, Hietbrink F, Leenen LPH, Houwert RM (2019) Intramedullary fixation versus plate fixation of distal fibular fractures: a systematic review and meta-analysis of randomized controlled trials and observational studies. J Foot Ankle Surg Off Publ Am Coll Foot Ankle Surg 58:119–126

    Google Scholar 

  6. Wilczek JL, LaPorta GA (2018) The evolution of limb deformity: what has changed over the past ten years? Clin Podiatr Med Surg 35:123–132

    Article  Google Scholar 

  7. Schneider W, Jurenitsch S (2016) Normative data for the American Orthopedic Foot and Ankle Society ankle-hindfoot, midfoot, hallux and lesser toes clinical rating system. Int Orthop 40:301–306

    Article  Google Scholar 

  8. Guo C, Ma J, Ma X, Wang Y, Sun L, Lu B, Tian A, Dong B (2018) Comparing intramedullary nailing and plate fixation for treating distal tibail fractures: a meta-analysis of randomized controlled trials. Int J Surg 53:5–11

    Article  Google Scholar 

  9. Lai TC, Fleming JJ (2018) Minimally invasive plate osteosynthesis for distal tibia fractures. Clin Podiatr Med Surg 35:223–232

    Article  Google Scholar 

  10. Xu H, Gu F, Xin J, Tian C, Chen F (2019) A meta-analysis of suprapatellar versus infrapatellar intramedullary nailing for the treatment of tibial shaft fractures. Heliyon 5:e02199

    Article  Google Scholar 

  11. Hu L, Xiong Y, Mi B et al (2019) Comparison of intramedullary nailing and plate fixation in distal tibial fractures with metaphyseal damage: a meta-analysis of randomized controlled trials. J Orthop Surg Res 14:30

    Article  Google Scholar 

  12. Inci F, Yildirim AO, Ciliz DS, Kocak C, Ceyhan E, Oken OF (2018) Intraoperative rotation control in closed intramedullary nailing in tibia diaphyseal fractures: a prospective, randomised study. Acta Orthop Belg 84:461–468

    PubMed  Google Scholar 

  13. Coster MC, Rosengren BE, Bremander A, Brudin L, Karlsson MK (2014) Comparison of the self-reported foot and ankle score (SEFAS) and the American Orthopedic Foot and Ankle Society score (AOFAS). Foot Ankle Int 35:1031–1036

    Article  Google Scholar 

  14. Sayyed-Hosseinian SH, Hassankhani GG, Bagheri F, Alavi N, Shojaie B, Mousavian A (2018) Validation of the Persian version of the American orthopedic foot and ankle society score (AOFAS) questionnaire. Arch Bone Joint Surg 6:233–239

    PubMed  Google Scholar 

  15. Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M, Lutter LD (1997) Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int 18:187–188

    Article  Google Scholar 

  16. Yavuz U, Sokucu S, Demir B, Yildirim T, Ozcan C, Kabukcuoglu Y S (2014) Comparison of intramedullary nail and plate fixation in distal tibia diaphyseal fractures close to the mortise. Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES 20:189-193

  17. Bilgili F, Kilic A, Sokucu S, Parmaksizoglu A S, Cepni K S, Kabukcuoglu Y S (2016) [Retrospective analysis of AO 42A-B type tibia fractures treated with percutaneus locked plating and intramedullary nailing]. Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES 22:90-96

  18. Yao Q, Ni J, Peng LB, Yu DX, Yuan XM (2013) Locked plating with minimally invasive percutaneous plate osteosynthesis versus intramedullary nailing of distal extra-articular tibial fracture: a retrospective study. Zhonghua Yi Xue Za Zhi 93:3748–3751

    PubMed  Google Scholar 

  19. Janssen KW, Biert J, van Kampen A (2007) Treatment of distal tibial fractures: plate versus nail: a retrospective outcome analysis of matched pairs of patients. Int Orthop 31:709–714

    Article  Google Scholar 

  20. Vallier HA (2016) Current evidence: plate versus intramedullary nail for fixation of distal tibia fractures in 2016. J Orthop Trauma 30(Suppl 4):S2–S6

    Article  Google Scholar 

  21. Moongilpatti Sengodan M, Vaidyanathan S, Karunanandaganapathy S, Subbiah Subramanian S, Rajamani SG (2014) Distal tibial metaphyseal fractures: does blocking screw extend the indication of intramedullary nailing? ISRN Orthop 2014:542623

    Article  Google Scholar 

  22. Meershoek AJ, Keizer J, Houwert RM, van Heijl M, van der Velde D, Wittich P (2019) Excellent functional recovery after Kirschner-wire extension blocking technique for displaced closed bony mallet finger injuries; results of 36 cases. Acta Orthop Belg 85:240–246

    PubMed  Google Scholar 

  23. Corey RM, Park NK, Cannada LK (2018) Segmental tibia fractures: an analysis of complication and healing rates. J Orthop Trauma 32:296–300

    Article  Google Scholar 

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Funding

This study was financially supported by the Project of Science and Technology Department of Shaanxi Province (2015SF116, 2016SF-340).

Author information

Author notes

  1. Yao Lu, Bo Wang and Bin Hu contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopaedic Surgery, HongHui Hospital, Xi’an Jiaotong University, 555 Youyi East Road, Xi’an, 710054, Shaan’xi Province, China

    Yao Lu, Bo Wang, Cheng Ren, Liang Sun, Ming Li, Hanzhong Xue, Zhong Li, Kun Zhang, Teng Ma & Qian Wang

  2. The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi’an Jiaotong University, Xi’an, 710049, China

    Yao Lu

  3. Bioinspired Engineering and Biomechanics Center (BEBC), Xi’an Jiaotong University, Xi’an, 710049, China

    Yao Lu

  4. Department of Hematology, Xi’an Gao Xin Hospital, Xi’an, 710054, Shaan’xi Province, China

    Bin Hu

  5. Yan’an University, Yan’an, 710000, Shaanxi, China

    Jie Li & Changjun He

Authors
  1. Yao Lu
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  2. Bo Wang
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  3. Bin Hu
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  4. Cheng Ren
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  5. Liang Sun
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  6. Ming Li
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  7. Jie Li
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  8. Changjun He
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  9. Hanzhong Xue
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  10. Zhong Li
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  11. Kun Zhang
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  12. Teng Ma
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  13. Qian Wang
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Corresponding authors

Correspondence to Teng Ma or Qian Wang.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

This study was approved by the ethics committee of HongHui Hospital, Xi’an Jiaotong University.

Consent to participate

All patients provided informed consent prior to participating.

Consent to publication

Informed consent for publication was obtained from all patients.

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Lu, Y., Wang, B., Hu, B. et al. Tibial shaft fractures treated with intramedullary nailing and reduction device assistance. International Orthopaedics (SICOT) 44, 2413–2420 (2020). https://doi.org/10.1007/s00264-020-04718-3

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  • DOI: https://doi.org/10.1007/s00264-020-04718-3

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