Reamed and Unreamed Intramedullary Nailing of Tibia Shaft Fractures - our Group of Patients and Literature Review
Authors:
Jan Trlica; Tomáš Dědek; Ivan Počepcov; Jan Folvarský; Jan Zahradníček; Ivo Žvák; Tomáš Holeček; Jaromír Kočí; Karel Šmejkal
Authors‘ workplace:
Surgery Department, University Hospital Hradec Králové
; Chirurgická klinika Fakultní nemocnice Hradec Králové
Published in:
Úraz chir. 16., 2008, č.3
Overview
Aim:
Evaluation of results in treatment of tibia shaft fractures by intramedullary nail and comparison with other authors.
Material and method:
Retrospective study of results in treatment of patient admitted to our department for tibia shaft fracture in 2002– 2004. All patients were operating by unreamed tibia nail (UTN, Synthes®). Minimal follow-up was 12 months after operation. Types of fracture, grade of soft tissue damage, time to union, early and late complications were recorded. Functional result was evaluated according to IOWA score.
Results:
48 patients of 108 (45 %) were checked up. In three cases (6,25 %) were recorded non - infectious complications. Any infectious complication was recorded. Compartment syndrome occurred in two cases (4,2 %) with close fracture. Average time to healing according to X-ray was 17,1 week. Average time to the full painless weight bearing was 24,1 week. Delayed union occurred in five cases (10,5 %). Nonunion wasn’t recorded. The anterior knee pain occurred in sex cases (12,5 %). Any implant failure was recorded.
Discussion:
In the case of closed fracture many studies evidence shorter time to healing with reamed nail because of his higher mechanical stability, but currently document longer operation time, X-ray exposure and blood loss quantity in comparison with unreamed nailing. In case of open fracture there are document more infection complications by reamed nailing and more implant failure by unreamed nailing, but time to healing is comparable.
Conclusion:
Ours records uncorresponded with some authors, especially in unreamed nailing of closed fractures. Possible explanation is that insufficient experience with unreamed nailing could bring more complications and longer time to healing because of lower mechanical stability compared with reamed nail.
Key words:
fracture, tibia, shaft, nail
Sources
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Surgery Traumatology Trauma surgeryArticle was published in
Trauma Surgery
2008 Issue 3
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