ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2023
The relevance of the number of distal locking planes and nail to canal ratio in bone healing after intramedullary nailing in tibial shaft fractures.
Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 5 citations in OpenAlex.
- Evaluation of the effectiveness of suprapatellar versus infrapatellar approach in intramedullary nailing for the treatment of tibial fractures.European journal of medical research · 2025Article
- Do two distal locking screws in two planes offer the best option in the nailing of diaphyseal tibial fractures?Journal of clinical orthopaedics and trauma · 2024Article
- Does the distal nail position impact the rates of misalignment and bone union in distal tibial fractures?European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023Review
- Intra-articular fracture patterns associated with tibial shaft fractures: more than just the posterior malleolus.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023Article
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Authors and funding
6 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
introductionThe objective of this retrospective study was to assess the effect of the nail to canal ratio and the number and configuration of distal locking screws in bone healing in tibial shaft fractures.
methodsWe analyzed 223 consecutive tibial shaft fractures treated with reamed intramedullary nailing between January 2014 and December 2020. We recorded and evaluated the nail to canal ratio (NCR) and the number and configuration of distal locking screws. Median NCR was 0.87 (IQR 0.82-0.94). Ten (4.48%) fractures were treated with one distal locking screw, 173 (77.57%) with two, and 40 (17.93%) with three. Uniplanar fixation was used in 63 (28.25%), biplanar in 150 (67.26%), and triplanar in 10 (4.48%) cases. Uni-, bi-, and multivariate analyses were performed to compare patients who achieved bone union with those who did not.
resultsBone union was achieved in 195 (87.44%) patients. Uni- and bivariate analyses showed that bone union increased significantly with larger NCR (p = 0.0001) and a greater number of locking planes (p = 0.001) and distal screws (p = 0.046). NCR > 0.78 (OR 48.77 CI 95% 15.39-154.56; p = < 0.0001) and distal locking screw configuration (OR 2.91 CI 95% 1.12-9.91; p = 0.046) were identified as independent variables for union.
conclusionOur findings suggest that in tibial shaft fractures treated with intramedullary nailing, NCR should be equal to or greater than 0.79. Additionally, distal locking screws should be used with a biplanar or triplanar configuration.
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