Evidence map›Paper›PMID 40335482›Full record

ArticleScientific reports2025

Surgical treatment of distal tibia non-unions with a retrograde intramedullary nail as a therapy option to prevent amputation.

Sebastian Findeisen, Jessica Böpple, Michael Tanner, Tim Bewersdorf, Christian Schamberger, Thomas Ferbert, Tobias Grossner, Gerhard Schmidmaier, Matthias Miska

Abstract read
In one paragraph

Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Sebastian Findeisen *Clinic for Trauma and Reconstructive Surgery, Center for Orthopedics, Trauma Surgery and Paraplegiology, University Hospital Heidelberg, Schlierbacher Landstraße 200a, 69118, Heidelberg, Germany. sebastian.findeisen@med.uni-heidelberg.de.
Jessica Böpple *Clinic for Trauma and Reconstructive Surgery, Center for Orthopedics, Trauma Surgery and Paraplegiology, University Hospital Heidelberg, Schlierbacher Landstraße 200a, 69118, Heidelberg, Germany.
Michael TannerClinic for Trauma and Reconstructive Surgery, Center for Orthopedics, Trauma Surgery and Paraplegiology, University Hospital Heidelberg, Schlierbacher Landstraße 200a, 69118, Heidelberg, Germany.
Tim BewersdorfClinic for Trauma and Reconstructive Surgery, Center for Orthopedics, Trauma Surgery and Paraplegiology, University Hospital Heidelberg, Schlierbacher Landstraße 200a, 69118, Heidelberg, Germany.
Christian SchambergerClinic for Trauma and Reconstructive Surgery, Center for Orthopedics, Trauma Surgery and Paraplegiology, University Hospital Heidelberg, Schlierbacher Landstraße 200a, 69118, Heidelberg, Germany.
Thomas FerbertClinic for Trauma and Reconstructive Surgery, Center for Orthopedics, Trauma Surgery and Paraplegiology, University Hospital Heidelberg, Schlierbacher Landstraße 200a, 69118, Heidelberg, Germany.
Tobias GrossnerClinic for Trauma and Reconstructive Surgery, Center for Orthopedics, Trauma Surgery and Paraplegiology, University Hospital Heidelberg, Schlierbacher Landstraße 200a, 69118, Heidelberg, Germany.
Gerhard SchmidmaierClinic for Trauma and Reconstructive Surgery, Center for Orthopedics, Trauma Surgery and Paraplegiology, University Hospital Heidelberg, Schlierbacher Landstraße 200a, 69118, Heidelberg, Germany.
Matthias MiskaClinic for Trauma and Reconstructive Surgery, Center for Orthopedics, Trauma Surgery and Paraplegiology, University Hospital Heidelberg, Schlierbacher Landstraße 200a, 69118, Heidelberg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Compared to other long bones, non-unions of the tibia after fractures are more likely. Due to surgical debridement, the residual bone stock in the distal part of the bone may be insufficient for adequate fixation of an implant. Thus, treatment with a retrograde nail with the additional performance of an arthrodesis of the hindfoot may be an alternative. The aim of this study was to examine the consolidation and reinfection rates of non-unions of the distal tibia treated with a retrograde arthrodesis nail. A total of 27 patients between 2010 and 2018 were included according to our inclusion criteria. The modified Lane Sandhu Score was used for the radiographic evaluation. The osseous consolidation was validated after 1 year as well as after 2 years. Furthermore, we investigated differences in surgical treatment and treatment-associated complications. One year after the initial therapy 48% of the patients showed osseous consolidation, 75% showed consolidation after two years. 14% underwent amputation later. The majority of the patients (77%) received the ETN PROtect (Expert Tibia Nail PROtect) retrogradely, while the rest were obtained with the HAN (Hindfoot Arthrodesis Nail). Major revision surgeries were required in 26% of patients, while minor revisions were necessary in 15% of patients. In conclusion, treatment with a retrograde nail is a safe treatment option for distal tibia non-unions with a satisfactory overall fusion rate. Therefore, it can be an effective option especially in cases, where the fixation of the implant is difficult, in order to prevent amputation.

Indexed as

Amputation, SurgicalBone NailsFracture Fixation, IntramedullaryFractures, UnunitedTibiaTibial FracturesAdultAgedArthrodesisFemaleHumansMaleMiddle AgedReoperationRetrospective StudiesTreatment OutcomeHANHindfoot arthrodesisNon-union therapy

Identifiers

PMID40335482
PMCPMC12058970

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.