BACKGROUND: Tibial spiral fractures treated by closed intramedullary (IM) nailing are at risk for malrotational deformities. The purpose of this study was to examine a method to minimize the risk of tibial malrotation during closed IM nailing of spiral tibial fractures. METHODS: This trial is done through 24 patients of spiral tibial fractures with a mean age of 38.5 years (range 26-63 years). The patients were divided into two groups. One group the fractures were reduced by rotating the distal locked nail to obtain rotational alignment and another group by the standard assistant rotated technique. All the patients were evaluated with CT scans postoperatively. The parameters such as rotational values, operative and radiation exposure time were recorded and compared between two groups. Mann-Whitney test was used to test the significance of these parameters. RESULTS: The group using the tip had a smaller mean rotational value, which was (6.8° ± 2.1° vs. 11.8° ± 5.2°; P < 0.01). The mean operative time was not statistically different (70.6 ± 4.4 vs. 63.0 ± 2.9 min; P > 0.05), so did the mean radiation exposure time (48.1 ± 4.2 vs. 42.6 ± 4.8 s; P > 0.05). CONCLUSION: The described technique of rotating the nail after initial distal interlocking can correct rotational abnormalities in spiral tibial shaft fractures in the premise of not increasing the operative and radiation exposure times statistically.
BACKGROUND: Tibial spiral fractures treated by closed intramedullary (IM) nailing are at risk for malrotational deformities. The purpose of this study was to examine a method to minimize the risk of tibial malrotation during closed IM nailing of spiral tibial fractures. METHODS: This trial is done through 24 patients of spiral tibial fractures with a mean age of 38.5 years (range 26-63 years). The patients were divided into two groups. One group the fractures were reduced by rotating the distal locked nail to obtain rotational alignment and another group by the standard assistant rotated technique. All the patients were evaluated with CT scans postoperatively. The parameters such as rotational values, operative and radiation exposure time were recorded and compared between two groups. Mann-Whitney test was used to test the significance of these parameters. RESULTS: The group using the tip had a smaller mean rotational value, which was (6.8° ± 2.1° vs. 11.8° ± 5.2°; P < 0.01). The mean operative time was not statistically different (70.6 ± 4.4 vs. 63.0 ± 2.9 min; P > 0.05), so did the mean radiation exposure time (48.1 ± 4.2 vs. 42.6 ± 4.8 s; P > 0.05). CONCLUSION: The described technique of rotating the nail after initial distal interlocking can correct rotational abnormalities in spiral tibial shaft fractures in the premise of not increasing the operative and radiation exposure times statistically.
Authors: Alexander M Keppler; Konstantin Küßner; Anna-Lena Schulze; Eduardo M Suero; Carl Neuerburg; Maximilian Weigert; Christian Braun; Wolfgang Böcker; Christian Kammerlander; Christian Zeckey Journal: BMC Musculoskelet Disord Date: 2021-06-26 Impact factor: 2.362