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Journal articles on the topic 'Fracturas de la Tibia'
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Arroquy, Damian, Jorge Chahla, Gustavo Gomez Rodriguez, Alberto Cid Casteulani, Santiago Svarzchtein, Diego Gomez, and Cesar Pesciallo. "Enclavado endomedular en fracturas del tercio distal de tibia. [Intramedullary nailing in distal tibial fracture.]." Revista de la Asociación Argentina de Ortopedia y Traumatología 80, no. 4 (November 19, 2015): 266. http://dx.doi.org/10.15417/486.
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<p><strong>Resumen</strong></p><p>El objetivo de este estudio fue describir los resultados obtenidos con enclavado endomedular acerrojado en pacientes con fractura del tercio distal de tibia.</p><p><strong>Materiales y métodos</strong></p><p>Los criterios de inclusión del presente estudio fueron: pacientes esqueléticamente maduros con fracturas desplazadas del tercio distal de tibia, tratadas con clavo endomedular con un seguimiento mínimo de un año. Se excluyeron las fracturas expuestas Gustilo III y las fracturas tipo C de la clasificación AO (Trazo articular completo). La muestra quedo conformada por 35 pacientes. El tiempo de seguimiento postoperatorio fue de 29,2 meses. Se evaluó el tiempo de consolidación, consolidación viciosa y complicaciones. Los resultados funcionales fueron descriptos según el score AOFAS.</p><p><strong>Resultados</strong></p><p>De los 35 pacientes con fractura del tercio distal de tibia la totalidad de los mismos presentaron consolidación de la fractura. El tiempo promedio de consolidación fue de 17,2 semanas (rango:11-26). Del total de la muestra, 5 pacientes presentaron retardo de consolidación, requiriendo la dinamización del clavo en promedio a las 12 semanas.</p><p>La consolidación viciosa se hizo presente en 4(11,4%) pacientes. No encontramos diferencia estadística (<em>p</em>: 0,201) en el tiempo de consolidación entre las fracturas asociadas con fracturas del peroné tratadas (13sem) o no (17sem). El score AOFAS, fue de 86 puntos.</p><p><strong>Conclusión</strong></p><p>Se plantea el enclavado endomedular con múltiples cerrojos distales como una buena alternativa de tratamiento para las fracturas de tibia distal AO tipo A o B, con bajo porcentaje de complicaciones y un alto índice de consolidación.</p>
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Navarro Lozano, Carlos Alberto, and Juvenal Bayona Mora. "Síndrome de embolismo graso." Revista Repertorio de Medicina y Cirugía 14, no. 1 (March 1, 2005): 12–15. http://dx.doi.org/10.31260/repertmedcir.v14.n1.2005.370.
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Antecedentes: los pacientes con fracturas diafisiarias de huesos largos con hipovolemia e hipoxia presentan mayor riesgo del síndrome de embolismo graso (SEG). El manejo temprano con líquidos endovenosos y oxigenoterapia puede prevenirlo. La incidencia en el hospital de San José es 7 %.Objetivo: establecer la frecuencia de SEG en los pacientes que acudieron entre febrero y diciembre de 2003, con fracturas diafisiarias de fémur y/o tibia, manejados desde el ingreso con líquidos endovenosos y oxígeno.Diseño: estudio observacional, retrospectivo y descriptivo, tipo serie de casos.Lugar: hospital de San José (nivel IV).Resultados: de 59 pacientes, 35 (58%) ingresaron a urgencias en los primeros 60 minutos después del trauma, 26 (44%) presentaron fractura cerrada de tibia y 18 (30 %) fractura cerrada de fémur. Diez se consideraron polifracturados (17 %) y 3 (5%) politraumatizados. 48 (81%) sufrieron traumas de alta energía. En las primeras 24 horas se estabilizaron quirúrgicamente el 56%, 32 de ellos con clavos endomedulares con una duración promedio de 122 minutos. La incidencia de fracturas aisladas de fémur o tibia fue de 2.04%, de las cuales en politraumatizados fue de 10%. Los dos pacientes ingresaron en la primera hora postrauma con fracturas diafisiarias cerradas de fémur, uno con fractura tibial contralateral abierta y se estabilizaron dos horas después de su ingreso con fijadores externos en 80 minutos promedio. Ningún paciente falleció.Discusión: 1. El estudio no muestra influencia contundente de alguna de las variables manejadas, esto permite pensar que el SEG depende más de la respuesta propia del huésped a los ácidos grasos que de su origen. 2. La incidencia de SEG en este trabajo fue menor que la reportada en un estudio anterior en esta misma institución con igual población de pacientes, donde no se utilizó protocolo de líquidos endovenosos y oxígeno.
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Kanchanomai, Chaosuan, and Vajara Phiphobmongkol. "Biomechanical Evaluation of Fractured Tibia Externally Fixed With an LCP." Journal of Applied Biomechanics 28, no. 5 (November 2012): 587–92. http://dx.doi.org/10.1123/jab.28.5.587.
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A locking compression plate (LCP) can serve as an external fixation for fractured tibia. However, there is concern about the stability and endurance during partial weight bearing. This study was experimentally evaluated the effects of fracture gap sizes (1, 5, and 10 mm) on the stability and endurance of fractured tibia externally fixed with a 316L-stainless LCP. For stable fractured tibia (1-mm fracture gap), the large contact area of fracture surfaces resulted in nearly similar stiffness to that of intact tibia. The partial weight bearing is therefore possible. Whereas smaller contact area and no contact of fracture surfaces were observed for tibias with 5-mm and 10-mm fracture gaps, respectively. Their stiffnesses were significantly lower than those of intact tibia and tibia with 1-mm fracture gap. Thus, the partial weight bearing should be considered carefully in early phase of treatment. All LCP-tibial models were cyclically loaded beyond 500,000 cycles, that is, approximately 6 months of healing, without any failure of LCP. Thus, the failure of LCP is unlikely a critical issue for the present cases.
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Telenchana Chimbo, Paulo, Wilson Martínez Vizuete, Hernan Patricio Moyolema Chaglla, Diego Chimbo Luque, Edison Patricio Aynaguano, and Felipe Jiménez Pinto. "Manejo de las fracturas ipsilaterales de fémur y tibia en el Hospital Luis Vernaza de Guayaquil." Mediciencias UTA 3, no. 1 (March 6, 2019): 30. http://dx.doi.org/10.31243/mdc.uta.v3i1.150.2019.
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Introducción: El término de rodilla flotante se acuña a lesiones ipsilaterales y simultaneas de fémur y tibia que desconectan a la rodilla del resto de la extremidad. Son lesiones muy complejas con una alta tasa de complicaciones, producidas por mecanismos de alta energía, que causan daño esquelético extenso, de partes blandas y además se asocian con lesiones potencialmente mortales de la cabeza, tórax y abdomen.
Objetivo: Describir el tipo de tratamiento y los resultados funcionales de los pacientes con diagnóstico de fracturas ipsilaterales de fémur y tibia atendidos en el Hospital Luis Vernaza de Guayaquil.
Material y Métodos: Se realizó un estudio descriptivo retrospectivo en pacientes con fracturas ipsilaterales de fémur y tibia atendidos durante el año 2015 en el Hospital Luis Vernaza de Guayaquil. Los diagnósticos fueron codificados según la clasificación Fraser. Los datos de obtuvieron de las historias clínicas digitales, además se utilizó una base de datos creadas en Excel y para el análisis estadístico se utilizó Epi info 7.
Resultados: En el servicio de Traumatología del Hospital Luis Vernaza de Guayaquil, durante el año 2015 se atendieron 985 fracturas, de las cuales 15 fueron fracturas de fémur y tibia ipsilaterales (4 mujeres y 11 varones). El tratamiento definitivo en el caso de fractura de fémur fue 9 clavos endomedular, 4 fijaciones externas y 2 placas condilar bloqueo. En el caso de la fractura de Tibia se colocaron 4 clavos encerrojados, 9 fijaciones externas, 1 tornillos canulados + fijación externa y una Osteodesis con clavo Steimann. Los resultados funcionales se valoraron según los criterios de Karlstrom y Olerud, se consideraron satisfactorios en el 33% d ellos pacientes, regulares en el 27% y malos en el40% de los casos.
Conclusión: Las lesiones de rodilla flotante son fracturas muy complejas provocados por traumas de alta energía, lo cual compromete los resultados funcionales a pesar de recibir manejo inicial y osteosíntesis definitiva considerados adecuados
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Zamorano, Álvaro Igor, Carlos Felipe Albarrán, Pierluca Zecchetto, Andrés Sebastián Oyarzún, Luis Felipe Ramirez, Gabriel Ignacio Durán, Matías Alejandro Vaccia, and Luis Alberto Bahamonde. "Modelo Predictivo de la No Unión de Tibia." Revista Chilena de Ortopedia y Traumatología 61, no. 01 (March 2020): 018–22. http://dx.doi.org/10.1055/s-0040-1709722.
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Resumen Objetivos Estimar un modelo predictivo para la no-unión en pacientes que presentan fractura de tibia. Materiales y Métodos Estudio de cohorte retrospectivo, en pacientes con fractura de tibia operadas entre 2012 y 2018, con un mínimo de 12 meses de seguimiento, excluyendo amputaciones traumáticas. Realizamos un modelo de regresión logística con 13 variables descritas en la literatura. Se descartaron las variables estadísticamente no significativas y las que no causaban efecto de confusión. Se evaluó la bondad de ajuste mediante el test de Hosmer-Lemeshow y la discriminación del modelo con la curva ROC. Resultados Se incluyeron 411 fracturas de tibia, las variables estadísticamente significativas fueron: exposición ósea OR = 2,57(IC:1,15–5,75, p = 0,022), diabetes OR = 3,29(IC:1,37–7,91, p = 0,008) y uso de tutor externo OR = 1,77(IC:0,81–3,85), el que tuvo efecto de confusión. La bondad de ajuste demostró que los datos se ajustan adecuadamente al modelo (p = 0,35). La curva ROC demuestra un 70,91% de poder discriminatorio. Al evaluar aisladamente las fracturas expuestas, no hubo asociación estadísticamente significativa con ninguna variable. Discusión Al evaluar el modelo, obtuvimos una asociación estadísticamente significativa entre: no unión, exposición ósea, diabetes y uso de tutor externo, información concordante con la literatura. Al estudiar el subgrupo de fracturas expuestas, las demás variables son estadísticamente no significativas. Eso refleja que la exposición ósea es la variable que confiere mayor riesgo. El seguimiento adecuado de esos pacientes es fundamental dado este alto riesgo de evolucionar con no-unión. Conclusión En nuestra serie, la exposición ósea es el factor de riesgo más importante para presentar no unión de tibia.
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Yañez Arauz, Juan Manuel, Ignacio Arzac Ulla, Javier Del Vecchio, Andres Eksarho, Leandro Civetta, and Rodrigo Perez Davila. "Osteosíntesis mini-invasiva con placas bloqueadas en fracturas metafisarias distales de tibia. Resultados clínico-funcionales. [Minimally invasive plate osteosynthesis in distal metaphyseal fractures of tibia. Comparison of results between fractures AO 43A and AO 43C.]." Revista de la Asociación Argentina de Ortopedia y Traumatología 80, no. 3 (May 8, 2015): 185. http://dx.doi.org/10.15417/341.
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<p><strong>Introducción. </strong>Las fracturas distales de tibia son un desafío para el tratamiento debido a la escasa cobertura y particular vascularización. Los objetivos del presente estudio son analizar los resultados clínicos y funcionales de los pacientes con fractura de tibia distal; tratados con técnica MIPO (minimally invasive plate osteosynthesis) con placas bloqueadas; comparar los resultados del grupo de fracturas tipo AO 43A con las tipo AO 43C1-C2; y comparar los resultados MIPO con el tratamiento abierto convencional.</p><p> </p><p><strong><span style="text-decoration: underline;">Material y métodos</span></strong><strong>. </strong>Entre 2004 y 2012, se evaluaron 32 fracturas de tibia distal tratadas con técnica MIPO. 20 varones y 12 mujeres. Edad promedio: 40,1 años. El 59,4% presentó fracturas tipo AO 43A; y el 40,6% AO 43C. Tiempo trauma/cirugía: 6,8 días promedio. 24 casos presentaron fractura de peroné. Estadía hospitalaria: 1,5 días promedio. Seguimiento promedio: 39,6 meses, mediante score AOFAS y radiología. Se consignaron complicaciones. Se compararon resultados de grupos tipo AO A y los tipo AO C.</p><p> </p><p><strong><span style="text-decoration: underline;">Resultados</span></strong><strong>. </strong>Incremento del score AOFAS entre pre y post-operatorio: 73,3 puntos promedio. El grupo AO tipo A: media de 95,89 puntos AOFAS PO. El grupo AO tipo C1-2: media de 92,15 puntos PO. Carga del peso corporal: a las 8,7 semanas promedio. Comparando A= 43A y AO 43C: p: 0,46 (no significativa). Retorno a actividad previa a la lesión:9.3 meses promedio. Comparando tipo A y tipo C: p=0,16 (no significativa). Hubo 18,75% de complicaciones y retiro de osteosíntesis en 14 casos.</p><p> </p><p><strong><span style="text-decoration: underline;">Conclusiones</span></strong><strong>. </strong>La osteosíntesis mínimamente invasiva con placa y tornillos, es una buena opción para las fracturas de tibia distal; con buena evolución clínico-funcional, y escasas complicaciones comparadas a la cirugía abierta. Las fracturas 43A presentan menos complicaciones mayores que las 43C, tratadas con técnica MIPO.</p>
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Brenes Méndez, Marco. "Manejo de fracturas Abiertas." Revista Medica Sinergia 5, no. 4 (April 1, 2020): e440. http://dx.doi.org/10.31434/rms.v5i4.440.
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Las fracturas abiertas se caracterizan por la pérdida de la continuidad ósea y la exposición del foco de fractura con el medio externo, situación que las hace especialmente vulnerables a procesos infecciosos y múltiples complicaciones. La mayoría de fracturas abiertas son causadas por traumatismos de alta energía; ocurriendo más en hombres y siendo la tibia el hueso que se afecta con mayor frecuencia. Se clasifican según el mecanismo de lesión, la gravedad de lesión de los tejidos blandos, la configuración de la fractura y el grado de contaminación; siendo la más utilizada la clasificación de Gustilo y Anderson por su utilidad terapéutica. Los objetivos principales del tratamiento son prevenir la infección, estabilizar la fractura, conseguir la consolidación y restaurar la función; para ello es indispensable la instauración de una profilaxis antibiótica y un manejo adecuado de los tejidos blandos.
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Pereira, Sebastián, Gabriel Vindver, and Fernando Bidolegui. "Tratamiento de las fracturas complejas de platillo tibial con compromiso de la tuberosidad anterior de la tibia.[Treatment of complex tibial plateau fracture associated with anterior tibial tubercle involvement]." Revista de la Asociación Argentina de Ortopedia y Traumatología 83, no. 4 (November 13, 2018): 268–73. http://dx.doi.org/10.15417/issn.1852-7434.2018.83.4.831.
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Introducción: Las fracturas de ambos platillos tibiales ocurren por traumatismos de alta energía. A veces, pueden comprometer el tubérculo anterior de la tibia. Ni la clasificación de Schatzker ni la de la AO/OTA consideran la presencia de este fragmento. El objetivo de este estudio fue describir la incidencia y el manejo quirúrgico de este tipo de fracturas.Materiales y Métodos: Se realizó un estudio retrospectivo, entre 2009 y 2017, que incluyó 48 fracturas de ambos platillos tratadas con reducción y osteosíntesis, 10 presentaban un fragmento de la tuberosidad anterior asociado. Siete pacientes eran hombres y 3, mujeres. La edad promedio era de 33.5 años. Nueve fueron estabilizadas inicialmente con tutor externo. El fragmento de la tuberosidad se fijó con 2 tornillos de 3,5 mm (9 casos) y con una placa 1/3 de tubo (un caso). Un paciente tenía una fractura expuesta. El seguimiento mínimo fue de 12 meses.Resultados: En todos, se logró la consolidación ósea. No hubo infecciones. El rango de movilidad de la rodilla logrado fue de 10º de extensión (rango 0-20º) a 120º de flexión (rango 90-140º). En un caso fue necesario retirar el material de osteosíntesis. Un paciente requirió artroscopia para tratar una lesión meniscal.Conclusiones: El 20,8% de las fracturas de ambos platillos tibiales presenta un fragmento de la tuberosidad anterior de la tibia, según nuestra serie. La fijación de este fragmento con tornillos de 3,5 mm o una placa 1/3 de tubo bloqueada es una técnica eficaz para lograr una estabilidad adecuada del fragmento.
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Chandrakant, Kawalkar Abhijit, and Badole Chandrashekher Martand. "Distal Tibia Metaphyseal Fractures: Which is Better, Intra-medullary Nailing or Minimally Invasive Plate Osteosynthesis?" Journal of Orthopaedics, Trauma and Rehabilitation 24, no. 1 (June 2018): 66–71. http://dx.doi.org/10.1016/j.jotr.2017.09.004.
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Introduction Tibia fractures are the most common long bone fractures encountered by the orthopedic surgeons and distal tibia fractures have the second highest incidence of all tibia fractures after the middle third of tibia the distal tibial fractures are unique and are considered as most challenging fractures to treat due to its proximity to the ankle joint and its superficial nature. The objective of this study is to compare two osteosynthesis systems developed for surgical treatment of distal tibia fractures: the intramedullary nailing and the MIPPO technique. Methods The study was conducted between Jan 2011 to Dec 2012. 63 patients with extra-articular distal tibia fracture treated with intramedullary nailing and MIPPO technique were reviewed retrospectively and clinical outcome was evaluated according to American Orthopaedic Foot and Ankle Score. Results 31 patients were treated with intramedullary nail & 32 with MIPPO technique. Fibular fixation was done in cases where fibular fracture was at or below the level of tibial fractures. We found no difference in terms of time for fracture union, mal-union, non-union, duration of surgery and amount of blood loss. But there was significant difference in terms of infection and duration of hospital stay. Also weight bearing was possible much earlier in intramedullary group as compared to the MIPPO group. Conclusion Thus we conclude that intramedullary nailing is better choice of implant in patients with extra- articular distal tibia fractures & helps in early weight bearing and ambulation of patient with fewer complications.
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Pereira, Sebastián, Gabriel Vindver, and Fernando Bidolegui. "Tratamiento con clavo endomedular de las fracturas metafisarias proximales y distales de tibia. Abordaje pararrotuliano medial en posición de semiextensión." Revista de la Asociación Argentina de Ortopedia y Traumatología 85, no. 2 (May 2, 2020): 99–106. http://dx.doi.org/10.15417/issn.1852-7434.2020.85.2.974.
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El enclavado endomedular de las fracturas metafisarias de tibia se asocia con algunas complicaciones relacionadas con la necesidad de flexionar la rodilla durante la introducción del clavo endomedular con la técnica infrarrotuliana clásica. Es por ello, que se han diseñado diferentes abordajes para la colocación del clavo en una posición de semiextensión de rodilla. El objetivo fue evaluar nuestros resultados, de forma retrospectiva, con el abordaje pararrotuliano medial en semiextensión, para el tratamiento de las fracturas metafisarias proximales y distales de tibia con clavo endomedular.
Materiales y Métodos: Se incluyó a 23 pacientes con un seguimiento posoperatorio mínimo de un año. Doce eran fracturas distales de tibia; 9, proximales y 2, segmentarias. Se evaluaron el rango de movilidad de la rodilla, el dolor posoperatorio con la escala de Lysholm, el eje posoperatorio y la tasa de consolidación.
Resultados: El arco de movilidad de la rodilla fue de 125° (rango 110-140). Al año de la cirugía, 16 de 23 pacientes no tenían dolor, 5 de 23 refirieron un leve dolor durante la actividad física y 2, dolores intensos durante la actividad física. En todos los casos, se consiguió un eje posoperatorio aceptable y la consolidación ósea. Un paciente requirió un aumento con una placa e injerto óseo.
Conclusión: La colocación de un clavo de tibia a través de un abordaje pararrotuliano medial con la rodilla en semiextensión es una técnica segura y simple para el tratamiento de las fracturas metafisarias de tibia.
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Rahman, Md Asjadur, Md Shahidullah Kaiser, SM Roknuzzaman, and Nadim Ahmed. "Comparative Study between Intra-medullary Nailing and Minimally Invasive Plate Osteosynthesis (MIPO) in Closed Distal Tibia Fracture in a District Hospital in Bangladesh." Journal of Shaheed Suhrawardy Medical College 12, no. 1 (January 24, 2021): 33–37. http://dx.doi.org/10.3329/jssmc.v12i1.51616.
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Introduction: Tibia fractures are the most common long bone fractures encountered by the orthopedic surgeons and distal tibia fractures have the second highest incidence of all tibia fractures after the middle third of tibia the distal tibial fractures are unique and are considered as most challenging fractures to treat due to its proximity to the ankle joint and its superficial nature. The objective of this study is to compare two osteosynthesis systems developed for surgical treatment of distal tibia fractures: the intramedullary nailing and the MIPO technique.
Methods: The study was conducted between Jan 2018 to Dec 2019. 30 patients with extraarticular distal tibia fracture treated with intramedullary nailing and MIPO technique were reviewed retrospectively and clinical outcome was evaluated according to American Orthopaedic Foot and Ankle Score.
Results: 15 patients were treated with intramedullary nail and 15 with MIPO technique. Fibular fixation was done in cases where fibular fracture was at or below the level of tibial fractures. We found no difference in terms of time for fracture union, mal-union, non-union, duration of surgery and amount of blood loss. But there was significant difference in terms of infection and duration of hospital stay. Also weight bearing was possible much earlier in intramedullary group as compared to the MIPO group.
Conclusion: Thus we conclude that intramedullary nailing is better choice of implant in patients with extra- articular distal tibia fractures and helps in early weight bearing and ambulation of patient with fewer complications.
J Shaheed Suhrawardy Med Coll, December 2020, Vol.12(1); 33-37
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Golubovic, Zoran, Predrag Stojiljkovic, Lana Macukanovic-Golubovic, Dragan Milic, Sasa Milenkovic, Marko Kadija, Zoran Matovic, et al. "External fixation in the treatment of open tibial shaft fractures." Vojnosanitetski pregled 65, no. 5 (2008): 343–48. http://dx.doi.org/10.2298/vsp0805343g.
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Background/Aim. Besides the conquasant fractures, open tibia shaft fractures belong to the group of the most severe fractures of tibia. Open tibia shaft fracture is one of the most common open fractures of long bones. They most frequently occur as a result of traffic accidents caused by the influence of a strong direct force. Methods. Within the period from January, 2000 to December 31, 2005. at the Clinic for Orthopaedics and Traumatology, Clinical Center Nis, 107 patients with open tibial fractures were treated. We analyzed 96 patients with open tibial fracture. In the series analyzed, the male sex was prevalent - there were 74 men (77.08%). The mean age was 47.3 years. The youngest patient was 17 years old, while the oldest patient was 79. According to the classification of the Gustilo et al. in the analysed group there were 30 (31.25%) open tibial fractures of the I degree, 31 (32.29%) of the II degree, 25 (26.05%) of the III A degree, 8 (8.33%) of the III B degree and 2 (2.08%) of the III C degree. In 95 of the patients the treatment of open tibia shaft fractures consisted of the surgical treatment of wound and the external fixation of the fractured bone using "Mitkovic" type external fixator with a convergent method of pin applications. One primary amputations had been done in patients with grade IIIC open tibial fracture with large soft tissue defect. Results. Of the 96 open tibial fractures available for follow-up, 73 (76.04%) healed without severe complications (osteitis, pseudoarthrosis, valgus malunion and amputation). Ther were nine (9.38%) soft tissue pin track infections and six (6.25%) superficial wound infections. The mean time of union was 21 (14-36) week. Among severe local complications associated with open tibial fractures, in eight patients (8.33%) was registered osteitis, and in nine patients (9.38%) fracture nonunion and the development of pseudoarthrosis. Three of the patients (3.13%) had more than 10 degree valgus malunion. In one patients (1.04%) deep pin track infection developed. Two patients (2.08%) had below the knee amputation (one primary in patient with type III C open fracture and one secondary after the development of deep infections). Conclusion. Surgical treatment of wounds, external fixation, leaving the wounds open and performing necessary debridements, adequate drug therapy administration are essential for obtaining good results in patients with open tibial shaft fractures.
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Kumar, B. S. Vijaya. "Treatment of diaphyseal fractures of tibia with intramedullary interlocking nail." International Journal of Research in Orthopaedics 5, no. 5 (August 26, 2019): 783. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20193130.
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<p class="abstract"><strong>Background:</strong> The tibia, or shinbone, is the most commonly fractured long bone in the body. A tibial shaft fracture occurs along the length of the bone, below the knee and above the ankle. It typically takes a major force to cause this type of broken leg. Motor vehicle collisions, for example, are a common cause of tibial shaft fractures. In many tibia fractures, the smaller bone in the lower leg (fibula) is broken as well. The objective was to study fracture healing and union rates with closed intra-medullary interlocking nailing.</p><p class="abstract"><strong>Methods:</strong> Patients of both sexes belonging to adult age group presenting with fracture tibia to Orthopedic Department, Vydehi Institute of Medical Sciences, of are admitted from January 2015 to December 2015.<strong></strong></p><p class="abstract"><strong>Results:</strong> In the present study maximum number of patients belongs to 18 to 27 years age group (18 cases) followed by 28 to 37 years age group (15 cases), maximum number of patients sustained tibia fracture due to RTA (38 cases) followed by fall (12 cases), maximum number of patients sustained simple tibia fracture (32 cases), followed by type 2 compound tibia fracture (13 cases) and 36 patients had excellent functional results and 8 patients had good functional outcome, while only 4 patients had fair functional outcome.</p><p class="abstract"><strong>Conclusions:</strong> IM rods are secured within the bone by screws both above and below the fracture. The metal screws and the rod can be removed if they cause problems, but can also be left in place for life. Tibial rodding provides excellent fixation and alignment of the bones.</p>
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Taylor, Shea K., Andrew Sephian, and Timothy Clader. "Intraoperative tibial plateau fracture during bone preparation in a cruciate retaining primary total knee arthroplasty." BMJ Case Reports 13, no. 9 (September 2020): e233826. http://dx.doi.org/10.1136/bcr-2019-233826.
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Intraoperative fractures are a rare complication in total knee arthroplasty. Limited literature exists in regard to the incidence, mechanism of injury and management of intraoperative fractures. The authors report a unique case of an 80-year-old man who sustained a medial tibial plateau fracture that occurred intraoperatively during final tibia bone preparation with the use of the Woolley Tibia Punch (Innomed, Savannah, Georgia, USA). The fracture was managed with the addition of 4.5 mm cortical lag screws and the addition of a stemmed tibial implant to bypass the fracture. This is the first reported case in literature that describes an intraoperative medial tibial plateau that occurred through the use of a Woolley Tibia Punch. The authors recommend the consideration of drilling to prepare sclerotic bone for cement penetration rather than a punch in order to minimise the potential for intraoperative fractures that may occur with the use of a punch.
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Rochat, M., J. Ritchey, M. Payton, and D. Dugat. "Quantitative analysis of the intramedullary arterial supply of the feline tibia." Veterinary and Comparative Orthopaedics and Traumatology 24, no. 05 (2011): 313–19. http://dx.doi.org/10.3415/vcot-11-02-0025.
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SummaryObjectives: To quantitatively describe the intramedullary arterial supply of the adult feline tibia and determine if the arterial supply is significantly different from that of adult small dogs.Methods: Cadaveric feline and canine pelvic limbs were obtained to prospectively investigate the intramedullary arterial supply of the tibia. A microvascular injection and modified Spalteholz bone clearing technique were used to characterize and quantify the intramedullary arterial supply of the tibia. Statistical comparisons were made between cats and dogs for the percentage of intramedullary arterial supply (arterial density) and the diameter of the nutrient artery.Results: No significant difference was observed in the intramedullary arterial density between dog and cat tibiae. The feline nutrient artery diameter (0.55 ± 0.1 mm) was significantly greater than the canine nutrient artery (0.30 ± 0.04 mm) in the distal section of bone. Dogs subjectively had a greater number of branching vessels in the distal and mid-diaphyseal sections of bone when compared to cats.Clinical significance: Delayed fracture healing in the feline tibia does not appear to be associated with a lack of intramedullary arterial supply. A lack of diffuse arborization of the arterial supply to the middle and distal feline tibia may explain, at least in part, why feline tibial delayed or nonunions may be more common than in canine tibial fractures.
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Gandhi, Swati, Rajan K. Singla, Rajesh K. Suri, and Vandana Mehta. "DIAPHYSEAL NUTRIENT FORAMINA OF ADULT HUMAN TIBIA - ITS POSITIONAL ANATOMY AND CLINICAL IMPLICATIONS. Foramen nutricio diafisario de la tibia humana adulta – Su anatomía posicional y las implicancias clínicas." Revista Argentina de Anatomía Clínica 5, no. 3 (March 28, 2016): 222–28. http://dx.doi.org/10.31051/1852.8023.v5.n3.14079.
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El conocimiento del número y posición de los forámenes nutricios en los huesos largos es importante en los procedimientos ortopédicos, tales como la terapia de reemplazo de articulaciones, reparación de fracturas, injertos de hueso y micro-cirugía de hueso vascularizado. El presente estudio se llevó a cabo en el departamento de Anatomía, Colegio Médico Gubernamental de Amritsar. El estudio comprendió 100 tibias de humanos adultos obtenidas de 50 cadáveres masculinos y 50 femeninos. Todos los huesos del presente estudio presentaban el foramen nutricio situado en el tercio superior del eje y se dirigían hacia abajo. En la mayoría de los huesos, se encuentró lateral a la línea vertical en la superficie posterior de la diáfisis tibial. Las distancias medias de foramen nutricio de los extremos superior e inferior de la tibia eran mayores en los hombres en ambos lados. Además, estas mediciones mostraron valores más altos en los huesos de la mitad derecha. El conocimiento preciso de la ubicación de la forámenes nutricios en los huesos largos es útil en la prevención de las lesiones intra-operatorias en cirugía ortopédica, así como en cirugía plástica y reconstructiva y también es relevante en la práctica médico-legal. An understanding of the number and position of nutrient foramina in long bones is important in orthopedic procedures such as joint replacement therapy, fracture repair, bone grafts and vascularized bone microsurgery. The present study was conducted in the department of Anatomy, Govt. Medical College Amritsar. The study group comprised of 100 adult human tibiae obtained from 50 male and 50 female cadavers. All the bones of the present study depicted single nutrient foramen situated in the upper one third of the shaft and were directed downwards. In majority of the bones, it was located lateral to the vertical line on the posterior surface of tibial shaft. The mean distances of nutrient foramen from the upper and lower ends of tibia were found to be greater in males on both the sides. Also, these measurements showed higher values in the right sided bones.Precise knowledge of the location of the nutrient foramina in long bones is helpful in preventing intra-operative injuries in orthopedic as well as in plastic and reconstructive surgery and is also relevant in medicolegal practice.
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RUIZ SEMBA, Carlos, and Juan PRETELL MAZZINI. "Fracturas de tibia: Tratamiento con clavo intramedular no fresado (UTN). Experiencia en el Hospital Nacional Cayetano Heredia." Revista Medica Herediana 15, no. 2 (January 4, 2013): 70. http://dx.doi.org/10.20453/rmh.v15i2.791.
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Objetivo: Determinar la utilidad del uso del clavo sólido intramedular no fresado (UTN) en el tratamiento de las fracturas diafisiarias de tibia cerradas, expuestas y en seudoartrosis. Material y métodos: Se realizó un estudio de cohorte prospectivo y longitudinal en 12 pacientes con fractura diafisiaria de tibia tratados en el servicio de traumatología del Hospital Nacional Cayetano Heredia desde febrero 2000 hasta junio del 2001. La técnica usada para colocar el UTN fue la descrita en el Manual de Técnicas Quirúrgicas de la AO. El tiempo de seguimiento total fue de 1 año. Resultados: La consolidación con el uso de este clavo se dio en promedio a las 16 semanas, no presentándose ningún caso de no unión. A pesar de que algunos de nuestros pacientes presentaron lesiones en piel y tejidos blandos, no observamos infecciones superficiales ni profundas. Por otro lado el movimiento de la rodilla, tobillo y articulación subtalar, se inicio en el postoperatorio inmediato, logrando los pacientes hasta el momento un rango articular normal. Conclusiones: El Clavo Intramedular no fresado, es una buena alternativa en el tratamiento quirúrgico de las fracturas diafisiarias de tibia tanto cerradas y expuestas de Iº grado, así como en seudoartrosis, debido a todas las ventajas y buenos resultados obtenidos.
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Maha Putra, Anak Agung Gde Duta, and Made Agus Maharjana. "Arthroscopy pull through for management of eminentia tibia fracture in 15 years old adolescent: a case report." International Journal of Research in Medical Sciences 8, no. 12 (November 27, 2020): 4476. http://dx.doi.org/10.18203/2320-6012.ijrms20205327.
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Tibial eminence fractures are rare injuries. Multiple treatment techniques are described and there is a lack of consensus with regard to the choice of treatment. In this case, we present the left eminentia tibia fracture which stabilized using arthroscopy pull through technique in a 15 years old male adolescent. A male 15 years old adolescent complained of pain on his left knee after climbing a tree and jumped with his left knee in hyperextention. On physical examination, tenderness was felt around the apex of patella. Left knee X-Ray confirmed a fracture of eminentia tibia. On arthroscopic evaluation, there was a fracture of medial eminentia tibia meyers and mckeever IIIA. The fractures were treated by using 1 mm ethibond which was inserted through the anterior cruciate ligament and pull through the tibia plateau. 10 weeks evaluation after the procedure, patient was able to walk independently with full weight bearing and was able to flex his knee in 130˚ and full extension without any pain. Management of displaced fracture of eminentia tibia is somewhat controversial and the ideal method of fixation has not been defined. In this patient, there were perfect anatomic and functional outcome without any serious complication. Arthroscopic reduction and internal fixation by pull through suture provide perfect anatomic and functional outcome for displaced type II and type III tibial eminence fracture.
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Hirsch S., Michael, Fabiola Flores A., Oscar Ardiles C., and Daniel Rios Q. "Comprendiendo las fracturas triplanares de la tibia distal." Revista Chilena de Radiología 22, no. 3 (July 2016): 114–20. http://dx.doi.org/10.1016/j.rchira.2016.09.002.
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Golubovic, Ivan, Zoran Vukasinovic, Predrag Stojiljkovic, Zoran Golubovic, Sonja Stamenic, and Stevo Najman. "Open segmental fractures of the tibia treated by external fixation." Srpski arhiv za celokupno lekarstvo 140, no. 11-12 (2012): 732–37. http://dx.doi.org/10.2298/sarh1212732g.
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Introduction. Open segmental fractures of the tibia are rare but severe injuries. In these fractures the wide zone of injury (damage of all structures of the lower leg) creates very unsuitable biological conditions for healing of the fracture. Objective. The aim of our work was to present the results of treatment of patients with segmental open fractures of the tibia treated by external fixation. Methods. We analyzed treatment results of 21 patients with open segmental tibial fractures who were treated using the method of external fixation at the Clinical Center Nis from January 1, 1995 to July 31, 2010. The average age of the patients was 53 years; the youngest patient was 27 years and the oldest one 80 years. According to the Gustilo open fracture classification, there were 3 (14.3%) type I, 6 (28.6%) type II, 8 (38.1%) type IIIA, and 4 (19.0%) type IIIB. All the patients were treated by a unilateral type Mitkovic external fixator by Traffix Company. Results. Union was attained in 16 (76.2%) fractures without severe complications (pseudoarthrosis, chronic osteitis and angular deformities of over 10 degrees). Among severe complications associated with open segmental tibial fractures, in two cases we registered septic pseudoarthrosis, in one aseptic pseudoarthrosis and in two large angular deformities of the tibia after union, with a valgus of over 10 degrees and extremity shortening of over 2 cm which required additional surgery. Conclusion. External fixation by the use of Mitkovic external fixator is one of the methods of choice in the treatment of open segmental tibial fractures, which incorporated with antibiotic therapy provides good biomehanical conditions for segmental fracture healing that enables good stability of the segmental tibial fracture and decreases the risk of deep infections.
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Stoffel, Karl, Hanna Engler, Markus Kuster, and Walter Riesen. "Changes in Biochemical Markers after Lower Limb Fractures." Clinical Chemistry 53, no. 1 (January 1, 2007): 131–34. http://dx.doi.org/10.1373/clinchem.2006.076976.
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Abstract Background: The bone remodeling sequence after bone fracture changes the concentrations of biochemical bone markers, but the relationships of fracture size and of healing time to changes in biomarkers are unclear. The present pilot study was undertaken to determine the changes found in serum bone markers after plate osteosynthesis of closed distal tibial and malleolar fractures during a study period of 24 weeks. Methods: We measured tatrate-resistant acid phosphatase (TRACP 5b), collagen type I C-terminal telopeptide (ICTP), bone-specific alkaline phosphatase (bone ALP), osteocalcin (OC), procollagen type I C-terminal propeptide (PICP), procollagen type III N-terminal propeptide (PIIINP), and human cartilage glycoprotein 39 (YKL-40) in 20 patients with lower limb fractures (10 malleolar, 10 tibia). A physical examination and radiographs were completed to assess evidence of union. Results: All malleolar fractures healed within 6 weeks, whereas 2 tibial fractures did not show complete bone healing after 24 weeks. Changes were comparable but more pronounced in the tibia group, and marker concentrations remained increased at the end of study (bone ALP, 86 vs 74 U/L; OC, 14.9 vs 7.7 μg/L; ICTP: 5.6 vs 3.3 μg/L at day 84 after osteosynthesis, P <0.05 in tibia; 80 vs 70 U/L, 8 vs 5.2 μg/L, and 3.5 vs 3.2 μg/L, respectively, in the malleolar fracture group). Conclusions: In normal bone healing, changes in bone turnover markers were primarily dependent on the fracture size. Delayed tibia fracture healing may involve a disturbance in bone remodeling.
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Moon, Myung-Sang, Sang-Yup Lee, Dong-Hyeon Kim, and Min-Geun Yoon. "HEALING PATTERN OF THE INTERLOCKING INTRAMEDULLARY NAILED CLOSED TIBIAL SHAFT FRACTURES — EFFECT OF AGE, IM NAIL AND FIBULA ON CALLUS FORMATION." Journal of Musculoskeletal Research 19, no. 04 (December 2016): 1650017. http://dx.doi.org/10.1142/s0218957716500172.
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Objectives: To assess the healing pattern of the fractured tibial shaft with or without fibula fracture, fixated with locked intramedullary (IM) standard cannulated titanium nail in a group of patients in each decade; nonosteonal versus osteonal. Summary of background data: Up to now there have been many previous clinical studies on the nailed tibial shaft fractures. However, only a few animal experiments dealt with the callus type in healing, and a little human researches on the effect of the age and fixation device on callus formation in tibia at the two bone level of the lower limb were carried out. Material and Methods: 135 out of 168 patients with normally united closed tibial shaft fractures, fixated with titanium cannulated nail which showed good quality radiograms, were subjected to this study: 10 patients at minimum in each decade from late teens to 8th decade being regularly and radiographically followed were selected. Results: The nailed fractures united primarily by periosteal callus in the teenagers, while in the patients over third decade the fractures united by the intercortical uniting callus (osteonal). Conclusion: It was found that nail in tibia could not suppress the periosteal reparative reaction in the late teenagers which was suppressed in the adults. Union of the titanium nail-fixated adult tibial shaft fractures had to be depended primarily on osteonal healing because of the suppressed reparative periosteal reaction.
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Gramajo, Marisol, Ricardo Salvadó, and Julia Ovalle. "Pseudoartrosis congénita de la tibia en paciente con Neurofibromatosis tipo I." Revista médica (Colegio de Médicos y Cirujanos de Guatemala) 159, no. 1 (June 23, 2020): 65–67. http://dx.doi.org/10.36109/rmg.v159i1.165.
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La pseudoartrosis congénita de la tibia es una patología poco común que puede estar asociada a neurofibromatosis tipo I. Ocurre un caso de pseudoartrosis congénita de la tibia por cada doscientas cincuenta mil personas. Se sospecha cuando presentan múltiples fracturas patológicas. El abordaje es multidisciplinario, para su detección temprana y el diagnóstico de patologías asociadas; para mejorar la calidad de vida de los pacientes. Presentamos el caso de un paciente de tres años y siete meses con diagnóstico de pseudoartrosis congénita de la tibia, asociada a neurofibromatosis tipo I.
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Deahl, Lauren, Ron Ben-Amotz, Ana Caceres, and Kimberly Agnello. "Proximal tibial metaphyseal fractures in immature dogs." Veterinary and Comparative Orthopaedics and Traumatology 30, no. 04 (2017): 237–42. http://dx.doi.org/10.3415/vcot-16-11-0154.
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SummaryObjective: To describe proximal tibial metaphyseal fractures in immature dogs.Materials and methods: Medical records of immature dogs with metaphyseal fractures of the proximal tibia were reviewed and data were collected on signalment and history of trauma. Craniocaudal and mediolateral radiographs were evaluated for the determination of the bones fractured, location of the fracture within the bone, fracture configuration, and the presence of fracture segment displacement and angulation.Results: Eighteen dogs with 22 proximal tibial metaphyseal fractures fulfilled the inclusion criteria. All fractures had a curvilinear, complete fracture of the proximal tibial metaphysis. Displacement was identified in 16 fractures and angulation in 15 fractures. All affected breeds were terrier or small breed dogs less than six months of age. The majority of dogs weighed 5 kg or less at the time of injury. The most common type of trauma that occurred was a jump or fall from a short distance.Clinical significance: Proximal tibial metaphyseal fractures are an uncommon injury that occur in skeletally immature dogs from minimal trauma. Proximal tibial metaphyseal fractures have a characteristic curvilinear fracture configuration that affects mainly small breed dogs with a predominance for terrier breeds.Supplementary Material to this article is available online at https://doi.org/10.3415/VCOT-16-11-0154
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Valdés Santurio, E. R., V. Vallina García, and V. Álvarez Ortiz. "Fisiopatología y tratamiento de las fracturas diafisarias de tibia." Revista Española de Cirugía Ortopédica y Traumatología 52, no. 1 (February 2008): 47–63. http://dx.doi.org/10.1016/s1888-4415(08)74793-3.
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Olarte, Carlos Mario, Guillermo Rueda, Marla Karin Cuello, José Leonardo Tovar Curieux, Omar Ricardo Herrera Sánchez, and Meilyn Adriana Muskus Ealo. "Factores asociados con infección en fracturas diafisarias de tibia." Revista Colombiana de Ortopedia y Traumatología 31, no. 3 (September 2017): 142–49. http://dx.doi.org/10.1016/j.rccot.2017.04.006.
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Carroll, John J., Sean P. Kelly, James N. Foster, Derek A. Mathis, and Joseph F. Alderete. "Bilateral Proximal Tibia Stress Fractures through Persistent Physes." Case Reports in Orthopedics 2018 (December 6, 2018): 1–4. http://dx.doi.org/10.1155/2018/8181547.
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Introduction. Fatigue fractures are stress fractures resulting from repetitive trauma in areas of stress concentration. Prior case reports and studies have described stress fractures through persistent physes about the olecranon and distal fibula, as evidenced by hyaline cartilage on histologic analysis. However, there have been no documented proximal tibia stress fractures through persistent physes. Case Presentation. A 29-year-old military male basic trainee with varus alignment about his knees suffered bilateral medial tibial plateau stress fractures several weeks into military basic training. He underwent radiographic and laboratory evaluation of his stress fractures and eventual operative fixation of his bilateral tibial plateau fractures. Intraoperative specimens obtained from the fracture sites distal to the articular surface demonstrated abnormal fibrous appearing tissue. Histology demonstrated the presence of hyaline cartilage. Discussion. A 29-year-old military male basic trainee had bilateral proximal tibia stress fractures through persistent physes confirmed with biopsies demonstrating hyaline cartilage. Our belief is that the patient’s persistent physes placed him at a greater risk for stress fractures and these may benefit from fixation in soldiers and athletes.
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Gorosito Cinalli, Emmanuel Iván, Ernesto Lombardo, Juan Manuel Baravalle, Emanuel David González, Jeremías Derico, Julián Parma, Ignacio Quinto Pages, and Agustín Barbero. "Evaluación de la estabilización de fracturas expuestas de pierna grados I y II de Gustillo en la etapa aguda." Revista de la Asociación Argentina de Ortopedia y Traumatología 86, no. 2 (April 14, 2021): 159–66. http://dx.doi.org/10.15417/issn.1852-7434.2021.86.2.1061.
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Introducción: La fijación interna de las fracturas de pierna expuestas en la etapa aguda, es decir, dentro de las 24 h del trauma es un tema controvertido. El objetivo de este estudio fue evaluar las infecciones asociadas a la colocación de clavos endomedulares en la etapa aguda y a la colocación diferida, en la fijación de fracturas expuestas de pierna grados I y II de Gustillo.
Pacientes y Métodos: Se realizó un estudio de cohorte retrospectivo sobre el tratamiento en la etapa aguda de los pacientes que ingresaron en el hospital con fracturas expuestas de pierna entre 2015 y 2018. Se analizó la tasa de infecciones durante los primeros 6 meses después de la cirugía y se comparó la fijación en la etapa aguda con la fijación diferida.
Resultados: La fijación interna con clavos endomedulares en la etapa aguda, en pacientes con fracturas expuestas de pierna no aumentó, sino que disminuyó la tasa de infecciones en el control posoperatorio.
Conclusión: El estudio avala la colocación de clavos endomedulares en la etapa aguda, en pacientes con fractura de tibia expuestas.
Nivel de Evidencia: II
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Abdelaziz, Mohamed E., Gregory Waryasz, Daniel Guss, Seth O’Donnell, Brad Blankenhorn, and Christopher W. DiGiovanni. "Tibial Stress Fracture After Ankle Arthrodesis: Case Series with Different Treatment Modalities." Foot & Ankle Orthopaedics 4, no. 4 (October 1, 2019): 2473011419S0008. http://dx.doi.org/10.1177/2473011419s00081.
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Category: Ankle, Ankle Arthritis, Trauma Introduction/Purpose: End-stage ankle arthritis is frequently treated with tibiotalar or tibio-talar-calcaneal (TTC) arthrodesis, whose sequelae include adjacent joint arthritis presumptively due to the increased stress inherent to the loss of a motion segment. The loss of ankle motion may also stress the distal tibia, and individual case reports exist describing tibial stress fracture after ankle arthrodesis. These case reports do not describe operative treatment however. The purpose of this study is to report a case series of patients who presented with a stress fracture of the tibia after ankle arthrodesis, a subsegment of whom failed nonoperative management, highlighting related risk factors and treatment strategies. Methods: The medical records at two large academic medical centers were reviewed retrospectively, from 1990 to 2017 at the first center and from 2013 to 2017 at the second center, to identify patients who had undergone ankle arthrodesis. Any patient who subsequently developed a stress fracture of the tibia, confirmed clinically and/or radiographically, was included in the subsequent analysis. Patients with a history of stress fracture prior to arthrodesis or with non-tibia stress fractures were excluded. Patient demographics were collected alongside surgical technique, duration of postoperative non-weight bearing status, presence of medical co-morbidities including osteoporosis and tobacco use, location of tibial stress fracture, and treatment strategy. Results: Twelve patients out of 988 (1.2%) developed tibial stress fracture. Seven patients underwent isolated ankle arthrodesis, four underwent ankle arthrodesis subsequent to subtalar fusion with a resultant ankle nonunion in two requiring revision TTC nailing, and one underwent primary TTC arthrodesis. Four patients had fibular osteotomy, and four had the lateral malleolus resected. The stress fracture was at the level of fibular osteotomy in two patients, and at the proximal end of existing or removed implant in six patients. All patients were treated initially with immobilization and activity modification except for one who had fracture displacement and underwent immediate plate fixation, and three who failed to improve with nonoperative treatment required fixation (two intramedullary nails, one plate). Conclusion: Tibial stress fractures can occur after an isolated ankle arthrodesis but is likely potentiated in the setting of previously or concomitantly fused subtalar joint. Transition points are especially at risk, either at the proximal end of an implant or at the proximal extent of a fibular osteotomy. Critically, stress fractures may present many years after ankle arthrodesis, with an average of four years in this series. In our series one third of patients necessitated surgical management, underscoring the importance of accurate diagnosis. Ultimately patients appear to do well with surgical repair even if they fail initial nonoperative treatment.
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Li, Jiantao, Hao Zhang, Peng Yin, Xiuyun Su, Zhe Zhao, Jianfeng Zhou, Chen Li, Zhirui Li, Lihai Zhang, and Peifu Tang. "A New Measurement Technique of the Characteristics of Nutrient Artery Canals in Tibias Using Materialise’s Interactive Medical Image Control System Software." BioMed Research International 2015 (2015): 1–7. http://dx.doi.org/10.1155/2015/171672.
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We established a novel measurement technique to evaluate the anatomic information of nutrient artery canals using Mimics (Materialise’s Interactive Medical Image Control System) software, which will provide full knowledge of nutrient artery canals to assist in the diagnosis of longitudinal fractures of tibia and choosing an optimal therapy. Here we collected Digital Imaging and Communications in Medicine (DICOM) format of 199 patients hospitalized in our hospital. All three-dimensional models of tibia in Mimics were reconstructed. In 3-matic software, we marked five points in tibia which located at intercondylar eminence, tibia tuberosity, outer ostium, inner ostium, and bottom of medial malleolus. We then recorded Z-coordinates values of the five points and performed statistical analysis. Our results indicate that foramen was found to be absent in 9 (2.3%) tibias, and 379 (95.2%) tibias had single nutrient foramen. The double foramina was observed in 10 (2.5%) tibias. The mean of tibia length was 358 ± 22 mm. The mean foraminal index was 31.8% ± 3%. The mean distance between tibial tuberosity and foramen (TFD) is 66 ± 12 mm. Foraminal index has significant positive correlation with TFD (r = 0.721, P < 0.01). Length of nutrient artery canals has significant negative correlation with TFD (r = −0.340, P < 0.01) and has significant negative correlation with foraminal index (r=-0.541, P<0.01).
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Amin, Muhammad Qazi, Ashfaq Ahmed, Muhammad Imran, Naeem Ahmed, Shahzad Javed, and Amer Aziz. "TIBIAL SHAFT FRACTURES;." Professional Medical Journal 24, no. 01 (January 18, 2017): 75–81. http://dx.doi.org/10.29309/tpmj/2017.24.01.413.
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Background: Tibia is the most commonly fractured bone because of itsstructure and position. Tibial fractures are increasing with time to time and hence the morbidityand mortality are increasing despite proper public health efforts. There is a lack of nationalepidemiological data on the characteristics of patients with tibial shaft fractures. Therefore,epidemiological assessment is crucial for fracture. The purpose of this study was to provide upto-date information about patients baseline demographics, distribution of fracture classification,trauma mechanism and to formulate the preventive measures. Study Design: Retrospectivestudy. Setting: Emergency or OPD at Orthopaedics and Spine Centre, Ghurki Trust TeachingHospital, Lahore. Period: 1st January 2011 to 31st December 2015. Material and methods:Any type of diaphyseal tibial fracture. The data were taken from hospital database and includeclinical, epidemiological and radiological records. The results were analyzed using SPSS 20.Results: A total of 2120 patients were included in the study. 1980(93.4%) were male and 140(6.6%) were females. Male to females ratio were 14.14:1 with mean age of 33.28 ± 21.02.Between 0-20 years, 519(24.5%) of patients were admitted, 1021(48.2%) of patients werebetween 21-40 years, 467(22.0%) were between 41-60 years and only 113(5.33%) were above60 years. Type A2 in 444(20.9%) were the most common pattern of fracture found. The traumaswere most common in months of May, June and July and Motorbike accidents were the maincause. The mid shaft of tibia is the most commonly fractured i-e 1038 (49.0%) followed bydistal part i-e 611(28.8%) and the least is the proximal i-e 471(22.22%). Conclusion: Thisstudy shows AO-type 4A2 was the most common fracture type, representing 20.9% of all tibialshaft fractures. The individuals between 21-40 years were mostly affected and the motorbikeaccidents were found the main cause for such traumas.
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Șerban, Al, V. Botnaru, R. ,. Turcu, B. Obadă, and St Anderlik. "Fractures of the tibia shaft treated with locked intramedullary nail." ARS Medica Tomitana 19, no. 4 (November 1, 2013): 197–201. http://dx.doi.org/10.2478/arsm-2013-0035.
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Abstract Background: The gold standard treatment for complex fractures of tibial shaft is the reamed interlocking intramedullary nail. There has been some controversies about dynamization of statically locked nail, and some authors recommend routine dynamization for promotion of healing. This study evaluates the treatment of complex fractures of tibia shaft with static and dynamic interlocking intramedullary nail method. Methods: In this retrospective study, we studied 100 patients treated in Clinical Emergency Hospital Constanta between April 2012 - July 2013 diagnosed with tibia and fibula shaft fractures. They were treated by external fixation, and intramedullary nail. The intramedullary nail was blocked distally static or dynamic. Results: All patients achieved union during 12-18 weeks. The need of dynamization was required at 23 patients after 10 weeks from osteosynthesis. No significant complication was observed in our patients. Alignment of tibial fracture was perfect in all patients without any shortening and rotation. Conclusion: Locked intramedullary nailing is the treatment of choice for fractures of the tibial shaft.
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Oswald, S., S. Jäggin, G. Piskoty, S. Michel, J. A. Auer, and A. E. Fürst. "Fracture configurations of the equine radius and tibia after a simulated kick." Veterinary and Comparative Orthopaedics and Traumatology 21, no. 01 (2008): 49–58. http://dx.doi.org/10.3415/vcot-07-03-0022.
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SummaryThe objective of this postmortem study was to determine the fracture configurations of the equine radius and tibia after a simulated kick. Fracture configurations of 35 radii and 36 tibiae from 19 adult horses were evaluated after a simulated kick in an experimental exvivo study. The bones were dissected, the proximal and distal ends were embedded in resin, fixed horizontally and preloaded in compression, and a steel impactor, designed to simulate a shod equine hoof, was dropped from a height of three to six metres onto the diaphysis. The experiments were filmed with a high-speed camera (30,000 pictures/second). The bones were then photographed and radiographed using a C-arm based 3D imaging device. A software programme (Osirix) was used to reconstruct the fissured and fractured bones three-dimensionally on a computer screen for assessment of the fracture configuration and fissure lines. Incomplete fractures occurred in 26 bones and complete fractures in 42. The complete fractures included 22 butterfly and 20 simple fractures; the latter included 17 oblique, two transverse and one longitudinal fracture. Additional longitudinal fissures occurred in 98% of the fractures. The butterfly fragment was always located on the side opposite the impact. There was a significant correlation between the type of bone and the fracture configuration: butterfly and oblique fractures occurred more frequently in the tibia, and incomplete fractures occurred more frequently in the radius. The data collected can be used to optimize evaluation of fractures and fissures caused by a kick and thereby improve surgical stabilization.
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Rotella, Pablo S., Fernando R. Valero Barg, Mauricio D. Vittar, and Marcela A. D´Urso Villar. "Resultados funcionales y utilización del enclavado endomedular bloqueado en fracturas de tibia." Revista de la Asociación Argentina de Ortopedia y Traumatología 78, no. 3 (October 11, 2013): 120. http://dx.doi.org/10.15417/149.
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<div class="page" title="Page 1"><div class="layoutArea"><div class="column"><p><span><strong>Introducción: </strong></span>El enclavado endomedular bloqueado en fracturas diafisarias de tibia probó ser un valioso método de tratamiento, y sus resultados superan a los de la osteosíntesis con placas y el enclavado endomedular elástico con clavos múltiples.<br /> El objetivo de este trabajo fue evaluar los resultados funcionales con la utilización de este método en todas las lesiones en las que está indicada la estabilización con este tipo de implante, y con un seguimiento de 2 años.</p></div></div></div><div class="page" title="Page 1"><div class="layoutArea"><div class="column"><p><strong>Materiales y Métodos: </strong><span>Se estudiaron 112 pacientes tratados en el Servicio de Ortopedia y traumatología, desde marzo de 2000 hasta diciembre de 2009, sometidos a enclavado endomedular bloqueado como osteosíntesis primaria, con un seguimiento de 2 años. Las variables recabadas fueron: edad (años), sexo, infección, lesión vascular, deformidad, movilidad, dolor, marcha, actividad, tipo de fractura. Se realizó un análisis descriptivo de las variables involucradas en este estudio y de asociación mediante el puntaje de Jones y Wruhs. El nivel de confiabilidad utilizado fue del 5%.<br /> </span></p></div></div></div><div class="page" title="Page 1"><div class="layoutArea"><div class="column"><p><strong>Resultados: </strong><span>ciento siete (96%) de las 112 fracturas evaluadas tuvieron consolidación sin otros procedimientos, dentro de las 17 semanas. En la serie, hubo 5 casos de seudoartrosis, pero una fractura en tres niveles de la tibia consolidó en 32 semanas y una fractura de tercio distal consolidó en 24 semanas. Las complicaciones posoperatorias fueron escasas y, al finalizar el tratamiento, la mayoría de los pacientes regresó a sus actividades previas, tanto laborales como de la vida diaria. El índice de infección fue del 8,03%, con un seguimiento promedio de 27,48 meses.</span></p></div></div></div><div class="page" title="Page 1"><div class="layoutArea"><div class="column"><p><strong>Conclusión: </strong><span>En nuestra experiencia, es un método seguro, relativamente sencillo, con gran versatilidad y ofrece al paciente un confortable posoperatorio con muy buen resultado funcional. Por ello, lo consideramos de primera elección para tratar fracturas diafisarias de tibia. </span></p></div></div></div><p> </p><div class="page" title="Page 1"><div class="layoutArea"><div class="column"><p> </p></div></div></div>
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Kumar, Prashant. "Clinical Performance of Intramedullary Nailing system for Tibia Fractures: A Retrospective study." International Journal of Clinical Case Reports and Reviews 7, no. 03 (June 25, 2021): 01–05. http://dx.doi.org/10.31579/2690-4861/124.
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Background: The tibia, or shinbone, is the common fracture long bone in body. There are two option includes, reamed and unreamed of surgical treatment of fractures. Reamed nail has some advantage but they significantly harmful the endosteal circulation. Unreamed nail surplus the endosteal circulation but provide a less stable fixation. Afterward, because of ability to lock the nail proximally and distally, closed intramedullary nailing turned into an acknowledged treatment for closed shaft cracks during the ninth decade. Aim: The main objective is to treat the tibia fractures by implanting the Intramedullary nailing system (Interlocking cannulated tibia nail and Expert tibia nail) manufactured by Auxein Medical Private Limited, Sonipat, India. Material and Methods: In this retrospective study, studied the results of intramedullary tibia nail in treatment of tibia fracture. A total of 25 consecutive patients were included in this study (11male, 14 female and average age 42.9 years). Fracture type was classified as per the Muller AO classification of fracture. Results: The outcomes of clinical treatment were obtained in our study; No pain (92%), Mild pain (8%) after 2 year follow up. The follow up of patients were taken on 4-week, 1-year, 2-year according to VAS score. Paired t test was performed for statistical data analysis using Minitab and values of p<.05 were taken to indicate significant value with confidence interval of 95%. No implant related problem have been found like loosening, bending, corrosion etc. Conclusion: Our outcomes with interlocking cannulated and Expert tibial interlocking nailing are empowering and exhibit the advantages of new nailing framework. It has been concluded that intramedullary tibia nailing system is best method for treatment of tibia fracture with good results and outcomes.
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Vora, Dr Jinesh, Dr Divyesh Jetpariya, and Dr Kabir Desai. "Comparison of clinical, radiological, and functional outcome of closed fracture of distal third tibia treated with nailing and plate osteosynthesis." Surgical update: International Journal of Surgery and Orthopedics 6, no. 5 (September 24, 2020): 298–304. http://dx.doi.org/10.17511/ijoso.2020.i05.02.
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Aim: This is a prospective study of 30 patients with distal tibia fracture (Closed extra-articular distalthird tibia fractures - 4 to 11cm from tibial plafond) who underwent surgical fixation were included inthis study after excluding compound, pathological and pediatric fractures. Materials and Methods:15 underwent closed intramedullary interlocking nail and 15 were treated with plate osteosynthesis(MIPO). Results: The age distribution ranged from 23 to 68 years with the mean age of 39.4 years.The mode of injury in all patients was due to vehicle accidents. All 30 patients were classifiedaccording to AO classification of which 15 belonged to A1, 14 belonged to A2, and 1 belonged to A3.The time of fixation from injury varied from 6 hours to 18 days. Conclusion: Plate osteosynthesisby minimally invasive technique and Intramedullary interlocking nailing is an equally effectivemethod of stabilization for distal tibia fracture when considering the union rates and final functionaloutcome. However, malunion, nonunion and secondary procedures were more frequent afterintramedullary interlocking nail. In MIPO platting Infection followed by an exposed plate occurs in 2patients. Randomized prospective evaluation of distal tibia fractures may clarify the efficacy of plateversus nail treatment and optimize patient care.
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Mason, Lyndon, Lara Jayatilaka, Andrew Fisher, Lauren Fisher, and Andrew Molloy. "Anatomy of the Insertion of the Posterior Inferior Tibiofibular Ligament and the Posterior Malleolar Fracture." Foot & Ankle Orthopaedics 3, no. 3 (July 1, 2018): 2473011418S0034. http://dx.doi.org/10.1177/2473011418s00341.
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Category: Ankle Introduction/Purpose: The treatment of posterior malleolar fractures is developing. Our previous study on the anatomy of the posterior malleolar fracture identified only 49% of rotational push off fractures of the posterior malleolus had syndesmotic instabilities. This was against general thinking that fixation of such a fragment would stabilize the syndesmosis. Our aim in this study was to identify the extent of the posterior inferior tibiofibular ligament insertion on the posterior tibia and its relation to push off fractures. Methods: We examined 10 cadaveric lower limbs that had been preserved for dissection at the Human Anatomy and Resource Centre at Liverpool University in a solution of formaldehyde. The lower limbs were carefully dissected to identify the ligamentous structures on the posterior aspect of the ankle. Results: In all specimens, the tibial insertion of the PITFL encompassed 1/3 of the distal posterior tibia. In addition, the posterior intermalleolar ligament inserted onto the posterior tibia just medial to the tibialis posterior groove. Thus a rotational push off fracture would only cause syndesmotic injury if greater than a 3 rd of the posterior tibia was injured or occurred in combination with a ligamentous injury. This is in keeping with the clinical findings of only 49% syndesmotic instabilities with Haraguchi type 1 posterior malleolar fractures. Conclusion: Haraguchi type 1 posterior malleolar fractures (less than a 3 rd of the width of the posterior tibia) are unlikely to cause syndesmotic instabilities without the addition of a ligamentous injury.
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Yousaf, Sohail, Kapil Sugand, Mushahid Raza, and Palanisamy Ramesh. "Simultaneous Bilateral Stress Fractures in a Homemaker." Journal of the American Podiatric Medical Association 104, no. 5 (September 1, 2014): 518–21. http://dx.doi.org/10.7547/0003-0538-104.5.518.
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Stress fractures commonly occur in athletes and military cadets due to repetitive stress on the bony cortex. Stress fractures of the tibia are commonly localized proximally and occur during aerobic weightbearing exercises. This is an unusual case of bilateral simultaneous distal tibial stress fracture in a young homemaker.
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Vinchhi, Pratik J., Sharvil H. Gajjar, Tirth Vyas, and Yatin Patel. "Study of outcomes of metaphyseal plate fixation in extra articular lower tibia fractures in adults." International Journal of Research in Orthopaedics 3, no. 3 (April 25, 2017): 456. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20171550.
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<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">The purpose of the present study was to see results of metaphyseal plate fixation in fractures of distal tibia in adults.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This is a retrospective study of 45 patients with 45 open fractures of tibia operated primarily by either Solid Titanium or Stainless steel tibia interlocking nail within 24 hours of injury</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">In Our Study we had studied 30 lower tibial fractures treated by precontoured metaphyseal anatomical plate. 24 (80%) patients were male. 19 patients were 20-45 years age group. Mean age was 34 years. 24(80%) fractures were due to Road traffic accidents. We had 26 (86%) patients with closed fracture and 4(14%) patients with open fracture. Average time of surgery in our series was 52 minutes. 6(20%) patients had infection. And 2(6.67%) patients had nonunion and both were due to infection and required implant removal and conversion to external fixation. Average time for fracture union was 18 months. In our study of 30 patients 23(76.67%) patients had good to excellent results as assessed by AOFAS score. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">From this study we can conclude that when properly indicated the use of anatomically precontoured medial tibial metaphyseal plate in treatment of distal tibia fractures gives good union and good functional result.</span></p>
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Milenković, Saša, and Milan Mitković. "External Fixation of Extra-Articular Open Tibial Fractures." Acta Facultatis Medicae Naissensis 35, no. 4 (December 1, 2018): 330–36. http://dx.doi.org/10.2478/afmnai-2018-0035.
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Abstract External fixation is one of the most commonly used methods for the treatment of open tibial fractures. In everyday practice, for fixation of open tibial fractures we use the external fixator by Mitković. External fixator is unilateral and easy to use. This retrospective study included 59 patients with 59 open tibial fractures, of which 37 (62.71%) men and 22 (37.28 %) women, with mean age 43.92 (16-84) years. The fractures were localized in the proximal part of the tibia (11), tibial shaft (29) and distal part of the tibia (19). According to Gustilo classification, 12 (20.33 %) patients had Type I open tibial fractures, 15 (25.42%) patients had Type II open tibial fractures, and 32 (54.23%) (13 IIIA, 17 IIIB, 2 IIIC) patients had Type III open tibial fractures. The union rate without complications was 77.96 % (46). Nonunion and delayed union rate was 15.25 % (9). Malunion rate was 6.77% (4). Pin tract infection rate was 13.55 % (8). Compartment syndrome was observed in 5.08 % (3) of patients. The patients had fasciotomy done and the external fixator applied. The average time of fracture healing was 26 weeks (6.06 months). External fixation of open tibial fractures is a simple and effective method that enables the safe healing of fractures, early mobilization of patients, early weight-bearing as well as early rehabilitation.
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Al., Șerban, Obadă B., Turcu R., Anderlik St., and Botnaru V. "Distal tibial fracture treated by minimally invasive plate osteosynthesis after external fixation Retrospective clinical and radiographic assessment." ARS Medica Tomitana 20, no. 1 (February 1, 2014): 44–49. http://dx.doi.org/10.2478/arsm-2014-0009.
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ABSTRACT Fractures of the horizontal surface of the distal tibia are known commonly as pylon or plafond fractures, and represent 1-5% of lower extremity fractures, 7-10% of all tibial fractures. The protocol consisted of immediate (within eight to 24 hours) open reduction and internal fixation of the fibula, using a fibular plate or one third tubular plate and application of an external fixator spanning the ankle joint. In the second stage, the treatment of proximal and distal tibial fractures with close reduction and MIPPO technique can preserve soft tissue, simplify operative procedure and decrease wound, obtain rigid internal fixation and guarantee early function exercises of ankle joint. In this study we evaluated 22 patients treated in Clinical Emergency Hospital Constanta between April 2012 - July 2013 diagnosed with multifragmentary fractures of the distal tibia. This study evaluates the treatment of complex fractures of distal tibia with locked plate after external fixation. There were 17 males and 5 females of mean age 51,7 years (31-68). The mean follow-up period was 14 weeks. (Ranging from 9-16 weeks). All patients were fully weight bearing at 16 weeks (ranging 9-16 weeks) showing radiological union. There were no cases of failures of fixation, or rotational misalignment. No significant complication was observed in our patients. MIPO is an effective method of treatment for distal tibial fractures, reduce surgical trauma and maintain a more biologically favorable environment for fracture healing, reducing risks of infection and nonunion.
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Jain, Ravi Kant, Ajay Varun, Pranav Mahajan, and Mandar Deshpande. "Evaluation of mobilization in operated case of fracture tibia." International Journal of Research in Orthopaedics 5, no. 1 (December 25, 2018): 61. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20185073.
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<p class="abstract"><strong>Background:</strong> In spite of all the advances optimal method of treatment, fractures of the tibia still pose a challenge to the orthopaedic surgeons and thus the management of the fractured tibia requires the widest experience, the greatest wisdom, and the nicest of the clinical judgement in order to choose the most appropriate treatment for particular pattern of injury. Therefore, in this study we evaluated the role of mobilization efficacy and results of nailing and plating compression in management of tibial fractures and its VAS scoring.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study of fractures tibia in 150 cases aged from 18-60 years, out of which 109 (72.6%) were males. The left side was involved in 85(56.6%) patients and RTA was the major cause of the tibial fractures 98 (65.3%). Among the patients full weight bearing time was early (<3 weeks) with 90 (60%) and 60 (40%) patients within delay (>3 weeks) of surgery.<strong></strong></p><p class="abstract"><strong>Results:</strong> VAS score was significant better in early (<3 weeks) mobilization and in nailing treatment of tibial fractures in first month (7.8±074 and 7.6±0.81) and (2.1±0.8 and 1.8±0.65) at the final follow-up. Vas score correlation was significant with process and mobilization.</p><p class="abstract"><strong>Conclusions:</strong> We here conclude from our study that interlocking nailing appears to be promising method of treatment of unstable tibia fractures in adults without any external splintage after adequate stabilization and early weight bearing leading to excellent functional results in most of cases.</p>
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Amoako, Adae, Ayesha Abid, Anthony Shadiack, and Robert Monaco. "Ultrasound-Diagnosed Tibia Stress Fracture: A Case Report." Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders 10 (January 1, 2017): 117954411770286. http://dx.doi.org/10.1177/1179544117702866.
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Stress fractures are a frequent cause of lower extremity pain in athletes, and especially in runners. Plain imaging has a low sensitivity. Magnetic resonance imaging (MRI) or bone scan scintigraphy is the criterion standard, but expensive. We present the case of a young female distance runner with left shin pain. Plain radiography was unremarkable. Ultrasound showed focal hyperechoic elevation of the periosteum with irregularity over the distal tibia and increased flow on Doppler. These findings were consistent with a distal tibia stress fracture and confirmed by MRI. Examination of our case will highlight the utility of considering an ultrasound for diagnosis of tibial stress fracture.
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Uzun, Metin, Adnan Kara, Müjdat Adaş, Bülent Karslioğlu, Murat Bülbül, and Burak Beksaç. "Hindfoot Valgus following Interlocking Nail Treatment for Tibial Diaphysis Fractures: Can the Fibula Be Neglected?" Advances in Orthopedics 2014 (2014): 1–4. http://dx.doi.org/10.1155/2014/806363.
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Purpose. We evaluated whether intramedullary nail fixation for tibial diaphysis fractures with concomitant fibula fractures (except at the distal one-third level) managed conservatively with an associated fibula fracture resulted in ankle deformity and assessed the impact of the ankle deformity on lower extremity function.Methods. Sixty middle one-third tibial shaft fractures with associated fibular fractures, except the distal one-third level, were included in this study. All tibial shaft fractures were anatomically reduced and fixed with interlocking intramedullary nails. Fibular fractures were managed conservatively. Hindfoot alignment was assessed clinically. Tibia and fibular lengths were compared to contralateral measurements using radiographs. Functional results were evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Foot and Ankle Disability Index Score (FADI).Results. Anatomic union, defined as equal length in operative and contralateral tibias, was achieved in 60 fractures (100%). Fibular shortening was identified in 42 fractures (68%). Mean fibular shortening was 1.2 cm (range, 0.5–2 cm). Clinical exams showed increased hindfoot valgus in 42 fractures (68%). The mean KOOS was 88.4, and the mean FADI score was 90.Conclusion. Fibular fractures in the middle or proximal one-third may need to be stabilized at the time of tibial intramedullary nail fixation to prevent development of hindfoot valgus due to fibular shortening.
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Bandera, A., E. Román, E. Montañez, S. Cañada, and E. Queipo de Llano. "Fracturas articulares del tercio proximal de la tibia. Factores pronósticos." Revista Española de Cirugía Ortopédica y Traumatología 47, no. 4 (January 2003): 244–54. http://dx.doi.org/10.1016/s1888-4415(03)76109-8.
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Nork, Sean E., David P. Barei, Thomas A. Schildhauer, Julie Agel, Sarah K. Holt, Jason L. Schrick, and Bruce J. Sangeorzan. "Enclavado intramedular de las fracturas del cuarto proximal de tibia." Journal of Orthopaedic Trauma 20, no. 8 (September 2006): 589–90. http://dx.doi.org/10.1097/01.ftd.0000245388.10434.fb.
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Haonga, Billy T., Mapuor M. M. Areu, Sravya T. Challa, Max B. Liu, Edmund Elieza, Saam Morshed, and David Shearer. "Early treatment of open diaphyseal tibia fracture with intramedullary nail versus external fixator in Tanzania: Cost effectiveness analysis using preliminary data from Muhimbili Orthopaedic Institute." SICOT-J 5 (2019): 20. http://dx.doi.org/10.1051/sicotj/2019022.
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Introduction: Open tibia fractures are some of the most common types of Orthopedics injuries in low- and middle-income countries (LMICs). In Tanzania, open tibia fractures are treated either conservatively by prolonged cast or surgically by external fixation (EF) or intramedullary nail (IMN) when available. The cost of treatment and amount of time patients spend away from work are major economic concerns with prolonged casting and EF. The goal of this study was to determine the cost effectiveness of IMN versus EF in the treatment of open diaphyseal tibia fractures at Muhimbili Orthopaedic Institute (Dar es Salaam, Tanzania). Methods: This is a prospective randomized control study conducted of patients with a closeable AO/OTA 42 open diaphyseal tibia fracture. The patients underwent surgical fixation with either IMN or EF at Muhimbili Orthopaedic Institute (MOI), and were followed up at 2, 6, and 12 weeks postoperatively. A micro-costing method was used to estimate the fixed and variable costs of IMN and EF of the open diaphyseal tibial fracture. Results: The mean total cost per patient was lower for the IMN group ($425.8 ± 38.4) compared to the EF group ($559.6 ± 70.5, p < 0.001), with savings of $133.80 per patient for the IMN group. The mean hospital stay was 2.72 ± 1.40 days for the IMN group and 2.44 ± 1.47 days for the EF group (p = 0.5). Quality-adjusted life years (QALYs) were 0.26 per patient for the IMN group and 0.24 in the EF group at 12 weeks (p = 0.8). Ninety-two percent of patients in the IMN group achieved fracture union versus 60% in the EF group at three months postoperatively (p = 0.03). Conclusion: IM nailing of a closeable open diaphyseal tibial fracture is more cost effective than EF. In addition, IM nailing has better union rates at three months compared to EF.
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Githens, Michael, and Julius Bishop. "Complex Tibial Fractures: Tips and Tricks for Intramedullary Nail Fixation." Clinical Medicine Insights: Trauma and Intensive Medicine 5 (January 2014): CMTIM.S12264. http://dx.doi.org/10.4137/cmtim.s12264.
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Intramedullary nailing of metaphyseal and segmental tibia fractures can be technically challenging for a variety of reasons. Restoring length, alignment and rotation of the injured limb requires careful preoperative planning and meticulous attention to surgical technique, while avoiding common pitfalls. Understanding the deforming forces on the fracture segments and normal tibial osteology provides a background for recognizing the most common pitfalls when nailing these fractures. Many adjuncts for obtaining and maintaining fracture reduction while nailing have been described, including extended positioning, use of the femoral distractor, blocking screws, and provisional plating. We discuss these techniques as well as the role of intramedullary fixation for treating metaphyseal fractures with articular extension. The purpose of this paper is to describe the background and technique for a variety of operative tips and tricks to facilitate intramedullary nailing of metaphyseal and segmental tibia fractures.
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Gurung, Sandeep, Dipendra KC, and Roshni Khatri. "Elastic Stable Intramedullary Nailing for Treatment of Pediatric Tibial Fractures." Journal of Lumbini Medical College 4, no. 1 (June 30, 2016): 11. http://dx.doi.org/10.22502/jlmc.v4i1.82.
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Introduction: Tibia fractures in the skeletally immature patient can usually be treated with above knee cast or patellar tendon bearing cast. The purpose of our study was to evaluate epidemiology and outcome of Elastic stable intramedullary nailing fixation of pediatric tibial shaft fractures treated at our institution.
Methods: Over a period of one year, fifty pediatric patients of tibial shaft fractures, with average age of 9.68 yr (SD=2.37), were treated with elastic stable intramedullary nail. Demographic data, union and complication rate were evaluated.
Results: There were 36 closed and 14 open fractures. The average time to union was 11.6 weeks (SD=2.65) for close and 14.3 weeks (SD=2.62) for open fracture. There were no instances of growth arrest, remanipulations, or refracture.
Conclusion: We conclude that flexible intramedullary fixation is an easy and effective method of management of both open and closed unstable fractures of the tibia in children.
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Wang, Shun-Ping, Kun-Jhih Lin, Cheng-En Hsu, Chao-Ping Chen, Cheng-Min Shih, and Kang-Ping Lin. "Biomechanical Comparison of a Novel Implant and Commercial Fixation Devices for AO/OTA 43-C1 Type Distal Tibial Fracture." Applied Sciences 11, no. 10 (May 12, 2021): 4395. http://dx.doi.org/10.3390/app11104395.
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This study compares the novel Asia Distal Lateral Tibial Locking Plate mechanical stability to that of the current anterolateral and medial tibial plates based on finite element analysis. Four-part fracture fragment model of the distal tibia was reconstructed using CAD software. A load was applied to simulate the swing phase of gait. The implant stress and the construct stiffness were compared. The results of the anterolateral plate and the medial plate were similar and the displacement values were determined lower than those in the medial plate. In the simulated distal tibia fracture, the Aplus Asia Distal Lateral Tibial Locking Plate and medial distal tibial plate tibia fixations will lead to a stiffer bone-implant construct compared to the anterolateral distal tibial plate. Moreover, the stress in the Aplus Asia Distal Lateral Tibial Locking Plate was lower than those for the medial distal tibial plate and anterolateral bone plates. The Aplus Asia Distal Lateral Tibial Locking Plate has better stabilization and is an anterolateral plate that avoids more soft tissue damage than other bone plates. The Aplus Asia Distal Lateral Tibial Locking Plate could be one of a suitable design in tibia distal fracture fixation.