Trial reportBMC musculoskeletal disorders2025
Primary dynamization versus standard static interlocking nailing in treatment of tibial shaft fractures in adults: a randomized controlled trial.
Trial report in BMC musculoskeletal disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06147219 (Primary Dynamization Versus Standard Interlocking Intramedullary Nail in Treatment of Tibial Shaft Fractures in Adults), which is not on this map. Not yet cited in PubMed.
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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.
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Primary Dynamization Versus Standard Interlocking Intramedullary Nail in Treatment of Tibial Shaft Fractures in Adults
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInterlocking nail (ILN) is gold standard for fixation of tibial shaft fractures in adults. Delayed union and non-union of tibial shaft fractures requiring secondary dynamization are high even with modern ILN techniques. There is no consensus to which dynamization technique has better outcomes and fewer complications. The purpose of this randomised controlled trial (RCT) was comparison of functional and radiological outcomes of primary dynamization without proximal locking screws versus standard static ILN in treatment of middle or distal thirds tibial shaft fractures in adults.
methodsThis RCT study was conducted on 40 adult patients with middle or distal third tibial shaft fractures, treated by primary dynamization ILN without proximal locking (group A) or standard static ILN (group B), at orthopedics department of Sohag university hospital, between September 2022 and September 2024. Primary outcomes were rate of union, time to union, and incidence of complications. Secondary outcomes were Bostman knee score, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, and visual analog score (VAS).
resultsMean ages of patients at time of operation were 33.25 years for group A and 31.45years for group B. Duration of surgery in group A was 66.25 ± 4.83 min compared to group B 75 ± 5.38 min, (P = .044). The mechanism of injury in most of patients was road traffic accident. The mean time to complete radiographic union in group A was 14 ± 1.86 weeks compared to group B at 16 ± 1.86 weeks, (P < .001). Bostman knee score was higher in group A at 28.05 ± 2.33 points compared to group B at 26.1 ± 2.65 points, (P = .016). No statistically significant difference was found between the two groups with respect to AOFAS ankle-hindfoot score, VAS for pain, rate of union or incidence of complications, (P > .05).
conclusionBoth techniques achieved complete bony union and pain relief with minor complications. Primary dynamization of ILN tibia without proximal locking screws had advantages of shorter duration of surgery, faster radiographic complete union, and better functional outcomes. LEVEL OF EVIDENCE: Level II: Randomised controlled trial.
trial registrationThe trial was retrospectively registered at 19 November, 2023 at www. CLINICALTRIALS: gov (Trial Registry no: NCT06147219).
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