Your browser doesn't support javascript.
loading
Distal Nail Target and Alignment of Distal Tibia Fractures.
Brinkmann, Elyse; DiSilvio, Frank; Tripp, Michael; Bernstein, Mitchell; Summers, Hobie; Lack, William D.
Afiliación
  • Brinkmann E; Department of Orthopaedic Surgery, Loyola University Medical Center, Chicago, IL.
  • DiSilvio F; Department of Orthopaedic Surgery, Loyola University Medical Center, Chicago, IL.
  • Tripp M; Department of Orthopaedic Surgery, Loyola University Medical Center, Chicago, IL.
  • Bernstein M; Departments of Surgery and Pediatric Surgery, McGill University, Montreal, QC, Canada.
  • Summers H; Department of Orthopaedic Surgery, Loyola University Medical Center, Chicago, IL.
  • Lack WD; Department of Orthopaedic Surgery, Loyola University Medical Center, Chicago, IL.
J Orthop Trauma ; 33(3): 137-142, 2019 Mar.
Article en En | MEDLINE | ID: mdl-30779725
ABSTRACT

OBJECTIVES:

To assess the relationship between the distal nail target and postoperative alignment for distal tibia fractures treated with intramedullary nailing.

DESIGN:

Retrospective cohort study.

SETTING:

A single level 1 trauma center. PATIENTS/

PARTICIPANTS:

One hundred thirty distal tibia fractures treated with intramedullary nailing over a 10-year period. MAIN OUTCOME MEASUREMENTS Malalignment >5 degrees.

RESULTS:

Thirty-eight cases (29.2%) of malalignment >5 degrees included valgus (19 cases, 14.6%), procurvatum (13 cases, 10.0%), recurvatum (1 case, 0.8%), and combined valgus with procurvatum (5 cases, 3.8%). Medially directed nails demonstrated relative valgus (mean lateral distal tibia angle 86.4 vs. 89.4 degrees, P < 0.01) and more frequent coronal malalignment (24 of 78, 30.8% vs. 0 of 52, 0%, P < 0.01). Anteriorly directed nails demonstrated relative procurvatum (mean anterior distal tibia angle 82.8 vs. 80.9 degrees, P < 0.01) and more frequent sagittal malalignment (15 of 78, 19.2% vs. 3 of 52, 5.8%, P = 0.03). Malalignment was less common for nails targeting the central or slightly posterolateral plafond (0 of 30, 0% vs. 38 of 100, 38%), P < 0.01. Multivariate analysis demonstrated the distal nail target (P = 0.03), fracture within 5 cm of the plafond (P = 0.01), as well as night and weekend surgery (P = 0.03) were all independently associated with malalignment.

CONCLUSIONS:

Alignment of distal tibia fractures is sensitive to both injury and treatment factors. Nails should be targeted centrally or slightly posterolaterally to minimize malalignment. LEVEL OF EVIDENCE Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fracturas de la Tibia / Desviación Ósea / Fijación Intramedular de Fracturas / Fracturas Abiertas Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: J Orthop Trauma Asunto de la revista: ORTOPEDIA / TRAUMATOLOGIA Año: 2019 Tipo del documento: Article País de afiliación: Israel

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fracturas de la Tibia / Desviación Ósea / Fijación Intramedular de Fracturas / Fracturas Abiertas Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: J Orthop Trauma Asunto de la revista: ORTOPEDIA / TRAUMATOLOGIA Año: 2019 Tipo del documento: Article País de afiliación: Israel
...