The relevance of the number of distal locking planes and nail to canal ratio in bone healing after intramedullary nailing in tibial shaft fractures. Am J Sports Med. She was able to return to full unrestricted activities, including high-level sports participation. The site is secure. Intramedullary nails; Upper limb We report the case of a 28-year-old male semiprofessional basketball player who presented to an outside hospital with nonhealing stress fractures for which he underwent tibial intramedullary nailing (IMN). Mid-diaphyseal anterior tibial stress fractures can be debilitating injuries. 2019 Oct 4;7:397. doi: 10.3389/fped.2019.00397. Careers. Two weeks after surgery, he developed pain proximal and lateral to the knee. 2021 Sep 20;56(3):386-391. doi: 10.1007/s43465-021-00523-1. and transmitted securely. Nine randomised and two quasi-randomised clinical trials, involving a total of 2093 participants with 2123 fractures, were included. Overall, there is insufficient evidence to draw definitive conclusions on the best type of, or technique for, intramedullary nailing for tibial shaft fractures in adults. and transmitted securely. Each patient had an unusually narrow medullary canal, a thickened anterior cortex, and a linear unicortical fracture line on the anterior or tension side. Federal government websites often end in .gov or .mil. PMC Keywords: Further blood test analysis revealed a significant vitamin D deficiency. FOIA Before Unable to load your collection due to an error, Unable to load your delegates due to an error. Please enable it to take advantage of the complete set of features! 2019 Oct 4;7:397. doi: 10.3389/fped.2019.00397. Retrograde intramedullary nails with distal screws locked to the nail have higher fatigue strength than locking plates in the treatment of supracondylar femoral fractures: A cadaver-based laboratory investigation. The fracture went on to complete healing. Front Pediatr. Bookshelf doi: 10.3928/01477447-20140401-52. -. Position. 2016 Nov;30 Suppl 4:S17-S21. Case report: ischial stress fracture non-union in a college football player. Results: The differences between the two nails in the incidence of deep infection or neurological defects were not statistically significant.The trial comparing one distal screw versus two distal screws found no statistically significant difference in nonunion between the two groups. doi: 10.1002/14651858.CD008241.pub2. 2018 Feb;28(2):299-304. doi: 10.1007/s00590-017-2041-6. J Hip Preserv Surg. Both quasi-randomised trials were at high risk of selection bias. Intramedullary nailing of the tibia for chronic stress fracture has a high union rate, allows for a low complication rate, and allows for an early return to competitive sports. In each case there were several similarities in symptoms and, most notably, radiographic findings and failure of nonoperative therapy for more than 1 year. Bethesda, MD 20894, Web Policies 8 Pain in the knee is a frequent complication in 22% to 71% of the . Two-year post-operative radiographs with tibial nail, anterior cortical thickening, and resolution. : Commentary on an article by Zachery Hong, MPHS, et al. Chronic tibial stress fracture is an unusual condition that is primarily seen in athletes and military personnel. However, the risk of anterior knee pain following intramedullary nail . Zbeda RM, Sculco PK, Urch EY, Lazaro LE, Borens O, Williams RJ, Lorich DG, Wellman DS, Helfet DL. The appearance of the "dreaded black line" is indicative of nonunion, an indication for surgery.11, 17 There are 2 surgical treatment options to treat anterior tibial stress fractures, namely, intramedullary nail or anterior tibial plating. 2022 Sep 23;18:945-954. doi: 10.2147/TCRM.S379135. Please enable it to take advantage of the complete set of features! Hypothesis: A plate will be more effective than an IM nail in preventing the opening of a simulated anterior midtibial stress fracture from tibial bending. 2012 Jan 18;1:CD008241. Chronic tibial stress fracture is an unusual condition that is primarily seen in athletes and military personnel. 2014 Dec;9(4):753-826. doi: 10.1002/ebch.1987. MeSH Surgical intramedullary nailing is recommended in the presence of an anterior tibia tension-sided stress fracture ("dreaded black line"). The osteosynthesis of a tibial diaphyseal fracture with a locked intramedullary nail (LIN) is recommended by various authors due to the high union rates, low infection and deformity rates, and good functional results. Chan DS, Nayak AN, Blaisdell G, James CR, Denard A, Miles J, Santoni BG. government site. Tension Band Plating for Chronic Anterior Tibial Stress Fractures in High-Performance Athletes. The fracture must be reduced to allow guide-wire placement, during reaming, and during nail insertion. Background:Anterior midtibial stress fractures are an important clinical problem for patients engaged in high-intensity military activities or athletic training activities. 'Moderate' quality evidence suggests that there is no clear difference in the rate of major re-operations and complications between reamed and unreamed intramedullary nailing. Pre-operative radiographs with anterior cortical. Am J Sports Med. Fresh-frozen human tibias were loaded by applying a pure bending moment in the sagittal plane. If Socioeconomic Stress Is a Relevant Factor in Fracture-Healing Outcomes, Should It Also Merit Intervention? Orthopedics. The evidence was dominated by one large multicentre trial of 1319 participants. 2014 Sep 12;(9):CD004961. While inconclusive, the evidence from a subgroup analysis suggests that reamed nailing is more likely to reduce the incidence of major re-operations related to non-union in closed fractures than in open fractures. Background: The Use a Prophylactic Intramedullary Tibial Nail for a Stress Fracture in a High-Level Athlete. -, Chang PS, Harris RM. 2022 May;18(2):284-289. doi: 10.1177/15563316211008176. With newer nail designs and attention to technique, nailing can be extended to both proximal and distal extraarticular fractures. See this image and copyright information in PMC. Careers. Would you like email updates of new search results? The nail design determines the number, location, and orientation of distal interlocking screws. Reamed intramedullary nailing has, however, a lower incidence of implant failure than unreamed nailing. Intramedullary stabilization of the tibia is indicated in patients with multiple injuries; an ipsilateral fracture of the femur, ankle, or foot; a vascular injury; compartment syndrome; and bilateral fractures. intramedullary nailing may be extended proximally or distally, but they. He presented . The clinical decision, after failure of conservative treatment, was made to treat the patient with tibial intramedullary nailing. J Orthop Case Rep. 2020 Dec;10(9):114-117. doi: 10.13107/jocr.2020.v10.i09.1928. 2006;14(10 Spec No.):S131-5. 2006;25:3752. Am J Sports Med. Would you like email updates of new search results? Chronic anterior midtibial stress fractures in athletes treated with reamed intramedullary nailing. The .gov means its official. Clipboard, Search History, and several other advanced features are temporarily unavailable. We performed a retrospective review of five patients who underwent intramedullary tibial nailing for recalcitrant stress fractures at Womack Army Medical Center, Ft. Bragg, North Carolina, from 1991 to 1994. Epidemiology. Antibiotic artificial bone implantation and external fixation for the treatment of infection after intramedullary nail fixation: a retrospective study of 33 cases. Epub 2015 Mar 31. Fractures located in the middle two thirds of the tibia that are amenable to nailing include transverse, short oblique, spiral . Anterior stress fractures of the tibial shaft are tension-sided high-risk stress fractures with significant risks of delayed union, nonunion, and fracture propagation. Our case report specifically describes a case of a high-level athlete with multiple anterior tibial linear cortical defects from a chronic stress fracture. Accessibility FOIA Reduction is an essential part of intramedullary nailing. Anterior tibial stress fracture treated with intramedullary nailing: a case report Clin J Sport Med. Concurrent Bilateral Anterior Tibial Stress Fractures and Vitamin D Deficiency in an Adolescent Female Athlete: Treatment With Early Surgical Intervention. The trials evaluated five different comparisons of interventions: reamed versus unreamed intramedullary nailing (six trials); Ender nail versus interlocking nail (two trials); expandable nail versus interlocking nail (one trial); interlocking nail with one distal screw versus with two distal screws (one trial); and closed nailing via the transtendinous approach versus the paratendinous approach (one trial).No statistically significant differences were found between the reamed and unreamed nailing groups in 'major' re-operations (66/789 versus 72/756; risk ratio (RR) 0.88, 95% confidence interval (CI) 0.64 to 1.21; 5 trials), or in the secondary outcomes of nonunion, pain, deep infection, malunion and compartment syndrome. Am J Sports Med. 1996;24:68892. Clin J Sports Med. J Orthop Trauma. government site. J Am Acad Orthop Surg. . Equipment. eCollection 2019. doi: 10.1002/14651858.CD009076.pub2. 1 Most tibial diaphyseal fractures are optimally treated with a reamed, locked intramedullary nail. patient supine with feet at the end of the bed, small bump under ipsilateral thigh. Griffin XL, Parsons N, Zbaeda MM, McArthur J. Cochrane Database Syst Rev. The effect of concurrent fibular fracture on the fixation of distal tibia fractures: a laboratory comparison of intramedullary nails with locked plates. Epub 2015 Mar 31. The gold standard surgical treatment has traditionally been antegrade tibial intramedullary nailing. Selection criteria: When conservative management for mid-diaphyseal anterior stress fractures fails, the utilization of prophylactic tibial nailing is a viable option. 2013 Jun;21(6):1447-50. doi: 10.1007/s00167-013-2365-7. An official website of the United States government. For the 75% saw cut depth, the mean FOD values for all IM nail constructs were 13% to 17% less than those for the saw cut alone; the use of locking screws had no significant effect on the FOD. Bookshelf There were very few data on functional outcomes; and often incomplete data on re-operations. Intramedullary Nail and Plate Combination Fixation for Complex Distal Tibia Fractures: When and How? Authors' conclusions: At least two review authors independently performed study selection, risk of bias assessment, and data collection and extraction. We performed a retrospective review of five patients who underwent intramedullary tibial nailing for recalcitrant stress fractures at Womack Army Medical Center, Ft. Bragg, North Carolina, from 1991 to 1994. The site is secure. Epub 2005 May 11. Abstract. A tibial shaft stress fracture is an overuse injury where normal or abnormal bone is subjected to repetitive stress, resulting in microfractures. Shaner AC, Spiker AM, Goolsby MA, Kelly BT, Helfet DL. Both intramedullary nails were removed and a tension plate was applied with an autologous iliac crest graft on the right tibia. Accessibility However, the right tibia subsequently developed nonunion. Effect of distal interlocking screw number and position after intramedullary nailing of distal tibial fractures: a biomechanical study simulating immediate weight-bearing. Metaphyseal-diaphyseal junctional fractures at the proximal or distal ends are more problematic to treat secondary . and transmitted securely. Unable to load your collection due to an error, Unable to load your delegates due to an error. Schmidt AH, Finkemeier CG, Tornetta P 3rd. Zha J, Zhang G, Wang X, Li J, Di J, Guo J. Ther Clin Risk Manag. Use of a Minimally Invasive Traction Repositor versus Conventional Manual Traction for the Treatment of Tibial Fractures: A Comparative Study from a Tertiary Hospital in China. Methods: Strauss EJ, Alfonso D, Kummer FJ, Egol KA, Tejwani NC. Careers. The purpose of our study was to highlight a case of an athlete sustaining a tibial stress fracture with multiple cortical defects. Anterior plate placement significantly decreased mean FOD values for both compression and locked plate constructs, but the mean percentage reductions for locked and unlocked plates were not significantly different from each other for either plate placement. 2015 Aug 13;2015(8):CD010606. Copyright: Indian Orthopaedic Research Group. Bookshelf We reviewed each case regarding preoperative symptoms, preoperative treatment, surgery performed, radiographic findings, and functional outcome. Clipboard, Search History, and several other advanced features are temporarily unavailable. Background: A chronic anterior midtibial stress fracture is a serious, difficult-to-treat injury that can adversely affect an athlete's career. Intramedullary nailing. 2005 Jul;33(7):1071-6. doi: 10.1177/0363546504271968. This article describes the use of intramedullary rodding as a treatment for an anterior tibial stress fracture in a patient with high functional demands: a professional ballet dancer. Request PDF | Anterior Tibial Stress Fractures - Intramedullary Nail versus Anterior Tension Band Plating | Lower extremity stress fractures are common overuse injuries in endurance athletes. Data collection and analysis: doi: 10.5435/00124635-200600001-00030. 2005 Jan;33(1):124-30. doi: 10.1177/0363546504266479. An extensometer spanning the defect was used to measure the fracture opening displacement (FOD) before and after the application of IM nail and plate fixation constructs. Disclaimer, National Library of Medicine When nonoperative treatment has failed, intramedullary (IM) nail and plate fixation are 2 surgical options used to arrest the progression of a fatigue fracture and allow bone healing. Unable to load your collection due to an error, Unable to load your delegates due to an error. The search was subsequently updated to September 2011 to assess the more recent literature. Chronic anterior midtibial stress fractures in athletes treated with reamed intramedullary nailing. Cruz AS, de Hollanda JP, Duarte A Jr, Hungria Neto JS. The percentage FOD reductions for all plate constructs and the unlocked IM nail were significantly less with a 50% saw cut depth. doi: 10.1002/14651858.CD008241.pub2. Background: Anterior midtibial stress fractures are an important clinical problem for patients engaged in high-intensity military activities or athletic training activities. The site is secure. J Orthop Case Rep. 2014 Jan-Mar;4(1):39-43. doi: 10.13107/jocr.2250-0685.147. Lateral fixation: an alternative surgical approach in the prevention of complete atypical femoral fractures. Internal fixation is appropriate in a small minority of cases w 8600 Rockville Pike To assess the effects (benefits and harms) of different methods and types of intramedullary nailing for treating tibial shaft fractures in adults. 'Low' quality evidence suggests that the Ender nail has poorer results in terms of re-operation and malunion than an interlocking nail. Tension band plating of an anterior tibial stress fracture nonunion in an elite athlete, initially treated with intramedullary nailing: a case report. 8600 Rockville Pike However, it found significantly more implant failures in the one distal screw group (13/22 versus 1/20; RR 11.82, 95% CI 1.70 to 82.38).One trial found no statistically significant differences in functional outcomes or anterior knee pain at three year follow-up between the transtendinous approach and the paratendinous approach for nail insertion. Cochrane Database Syst Rev. There must be enough screws appropriately distributed in the short distal tibial segment to provide sufficient stability. INTRODUCTION. MeSH If resistance is encountered, it may be caused by the wrong entry point, or the tip of the nail hitting the cortex of the distal fragment. Pesciallo CA, Garabano G, Alamino LP, Dainotto TL, Gaggiotti S, Del Sel H. Indian J Orthop. 2015 Jul;43(7):1712-8. doi: 10.1177/0363546515577355. Anterior midtibial stress fractures are an important clinical problem for patients engaged in high-intensity military activities or athletic training activities. Length, angulation, and rotation are all important to restore. Tension band plating of an anterior tibial stress fracture nonunion in an elite athlete, initially treated with intramedullary nailing: a case report. 8600 Rockville Pike Hua H, Zhang L, Guo Z, Zhong W, Chen J, Wang S, Guo J, Wang X. BMC Musculoskelet Disord. The nail should advance into the medullary canal with each tap of the hammer. This site needs JavaScript to work properly. Two-year post-operative radiographs with tibial. Bethesda, MD 20894, Web Policies Effectiveness of Nail Dynamization in Delayed Union of Tibial Shaft Fractures: Relationship Between Fracture Morphology, Callus Diameter, and Union Rates. Recurrent or recalcitrant stress fractures can be career-ending because they require lengthy nonoperative treatment. Epub 2018 Sep 7. These fractures are one of the most common long bone fractures in adults. Aneja A, Marquez-Lara A, Luo TD, Teasdall RJ, Isla A, Albano A, Halvorson JJ, Carroll EA. Bethesda, MD 20894, Web Policies Tibial Intramedullary Nailing: Technique. Madhuri V, Dutt V, Gahukamble AD, Tharyan P. Evid Based Child Health. 2012 Jan 18;1:CD008241. Conclusion: The .gov means its official. Accessibility Clin Sports Med. Plate fixation was superior to IM nail fixation in limiting the opening of a simulated midtibial stress fracture, and anterior-posterior placement of the plate was an important variable for this construct. 1996; Borden, Osbahr, and Jmenez 2001).Stress fractures comprise as many as 10% of all sport injuries, with the tibia accounting for approximately 50% of diagnoses in athletes (Bennell et al. Background: Leg pain in athletes is a common condition and is often related to tibial stress fracture. Interviews were used to survey the patient's history and outcome. Recurrent or recalcitrant stress fractures can be ca reer-ending because they requi. There were two excellent results (defined as unlimited pain-free running and resolved tibial pain) and three good results. 1995;5:5861. Summary: Tibial shaft fractures distal to total knee arthroplasty are rare, but they are likely to become more common with the increasing number of arthroplasty procedures being performed. Varner KE, Younas SA, Lintner DM, Marymont JV. 8600 Rockville Pike Tibial; intramedullary nail; sports medicine; stress fractures; trauma. An official website of the United States government. PMC official website and that any information you provide is encrypted Would you like email updates of new search results? 1995;5(1):58-61; discussion 61-2. doi: 10.1097/00042752 . Study design: Although intramedullary nailing can achieve satisfactory tibiotalocalcaneal arthrodesis, the stress risers in the tibial diaphyses do result in a stress reaction in a significant number . Intramedullary fixation is valuable and appropriate for the majority of tibial fractures. As he returned to play, the pain worsened with jumping and lateral movement and improved with rest. sharing sensitive information, make sure youre on a federal This chapter describes the evolution of the nails that are used to treat fractures in upper limb bones and systematically describes the pros and cons of each device. Advantages of nails include shorter operative times, improved postoperative function, and as much as a 2.5-fold reduction in wound complications. When . Intramedullary nailing for tibial shaft fractures in adults. Background:Intramedullary nailing of the fibula (FN) is a method of fixation that has proven to be useful for treating distal fibular fractures (DFs). We present an 18-year-old collegiate bound athlete who sustained a tibial stress fracture with multiple cortical defects. eCollection 2022. Epub 2021 Apr 15. J Med Case Rep. 2018 Jun 29;12(1):183. doi: 10.1186/s13256-018-1718-8. Tension band plating of an anterior tibial stress fracture nonunion in an elite athlete, initially treated with intramedullary nailing: a case report. Please enable it to take advantage of the complete set of features! These fracture patterns have been treated in the past either with closed reduction and casting/bracing or with open reduction internal fixation using plates. Concurrent Bilateral Anterior Tibial Stress Fractures and Vitamin D Deficiency in an Adolescent Female Athlete: Treatment With Early Surgical Intervention. IM nails were tested without locking screws, with a proximal screw only, and with proximal and distal screws. Nailing in fractures of the upper limb has evolved a long way, but has not paralleled the impact it has made in fractures of the lower limb. Duan X, Al-Qwbani M, Zeng Y, Zhang W, Xiang Z. Cochrane Database Syst Rev. Objectives: To assess the effects (benefits and harms) of different methods and types of intramedullary nailing for treating tibial shaft fractures in adults. Bone Joint J. Federal government websites often end in .gov or .mil. and transmitted securely. This site needs JavaScript to work properly. PMC Contraindications to intramedullary nailing include immature patients. Intramedullary nailing usually represents a relatively drastic step in the management of stress fracture, and the diagnosis of tibial stress fracture must be definitively confirmed before it is contemplated, which is not as trivial as it might seem. 2014;69(4):234-40. doi: 10.6061/clinics/2014(04)03. HHS Vulnerability Disclosure, Help This site needs JavaScript to work properly. We performed a retrospective review of five patients who underwent intramedullary tibial nailing for recalcitrant stress fractures at Womack Army Medical Center, Ft. Bragg, North Carolina, from 1991 to 1994. Anterior tibial stress fracture treated with intramedullary nailing:A case report. Before Chronic anterior midtibial stress fractures in athletes treated with reamed intramedullary nailing. official website and that any information you provide is encrypted Intramedullary nails for extracapsular hip fractures in adults. 1 The use of intramedullary nails for distal tibia fractures has been associated with a 12%-23% incidence of malunion, 1 but use of the suprapatellar insertion technique reduces this rate to 3.8% . Clipboard, Search History, and several other advanced features are temporarily unavailable. J Hip Preserv Surg. The .gov means its official. are associated with an increased risk of fracture malreduction. The clinical decision, after failure of conservative treatment, was made to treat the patient with tibial intramedullary nailing. Brukner P, Fanton G, Bergman AG, Beaulieu C, Matheson GO. When non-operative treatment fails, the optimal surgical treatment is controversial. The role of prophylactic intramedullary nailing in this difficult fracture is discussed. 2017 Mar;475(3):585-591. doi: 10.1007/s11999-016-5202-8. Results from these tests can help guide the selection of fixation hardware for patients requiring surgical treatment for a midtibial stress fracture. The Use a Prophylactic Intramedullary Tibial Nail for a Stress Fracture in a High-Level Athlete. HHS Vulnerability Disclosure, Help In our patient, a year of conservative treatment and later tibial drilling was unsuccessful. PMC 2022 Mar 5;23(1):209. doi: 10.1186/s12891-022-05161-8. Federal government websites often end in .gov or .mil. 1-7 However, up to 79% of patients need complementary procedures for certain complications. Before Shaner AC, Spiker AM, Goolsby MA, Kelly BT, Helfet DL. 2018 Aug 8;5(3):312-318. doi: 10.1093/jhps/hny019. Clinical relevance: Pre-operative radiographs with anterior cortical thickening and multiple linear cortical defects. 2014 Jan;96-B(1):114-21. doi: 10.1302/0301-620X.96B1.31135. The site is secure. biomechanics; intramedullary nail; locking compression plate; stress fracture. Chronic tibial stress fracture is an unusual condition that is primarily seen in athletes and military personnel. When nonoperative treatm. Shaner AC, Spiker AM, Goolsby MA, Kelly BT, Helfet DL. Anterior stress fractures of the tibial shaft are tension-sided high-risk stress fractures with significant risks of delayed union, nonunion, and fracture propagation. An official website of the United States government. They have been described occurring in athletes due to repetitive lower extremity trauma. Epub 2017 Sep 18. PMC -, Varner KE, Younas SA, Lintner DM, Marymont JV. Chronic Bilateral Tibial Stress Fractures with Valgus Treated with Bilateral Intramedullary Nailing: A Case Report. Accessibility -, Plasschaert VF, Johansson CG, Micheli LJ. HSS J. optional: large sharp periarticular clamps or Weber-style clamps. HHS Vulnerability Disclosure, Help A plate will be more effective than an IM nail in preventing the opening of a simulated anterior midtibial stress fracture from tibial bending. Kharazmi M, Michalsson K, Hallberg P, Schilcher J. Eur J Orthop Surg Traumatol. Bookshelf Recurrent or recalcitrant stress fractures can be ca reer-ending because they require lengthy nonoperative treatment. Recurrent or recalcitrant stress fractures can be career-ending because they require lengthy nonoperative treatment. eCollection 2019. 2018 Aug 8;5(3):312-318. doi: 10.1093/jhps/hny019. with open physes, patients with very small medullary canals, or a. history of tibial osteomyelitis. government site. Exclusion criteria included open fractures, fibular fractures in the context of distal tibia or pilon fractures, previous ipsilateral or contralateral ankle fractures, neuroarthropathy . 2005;33:10716. Effect of minimally invasive percutaneous plates versus interlocking intramedullary nailing in tibial shaft treatment for fractures in adults: a meta-analysis. Pekmezci M, McDonald E, Buckley J, Kandemir U. The .gov means its official. Recurrent or recalcitrant stress fractures can be ca reer-ending because they require lengthy nonoperative treatment. The decision for surgical intervention is dependent on many factors including patient's activity level and characteristics, failure of conservative management, and radiographic evidence of non-healing stress fractures. Study design: Case series; Level of evidence, 4. Varner KE, Younas SA, Lintner DM, Marymont JV. Background: Intramedullary nailing is commonly used for treating fractures of the tibial shaft. These fractures are one of the most common long bone fractures in adults. FOIA The site is secure. Queally JM, Harris E, Handoll HH, Parker MJ. : "The Effect of Social Deprivation on Fracture-Healing and Patient-Reported Outcomes Following Intramedullary Nailing of Tibial Shaft Fractures" Hypothesis: The use of a reamed intramedullary nail for a chronic anterior tibial stress fracture is a safe and effective treatment for an athlete. J Am Acad Orthop Surg. 2007 Mar;21(3):172-7. doi: 10.1097/BOT.0b013e3180332dd2. Controlled laboratory study. A complete posterior tibial stress fracture that occurred during a middle-distance running race: a case report. Clin Orthop Relat Res. sharing sensitive information, make sure youre on a federal Plate fixation was superior to IM nail fixation in limiting the opening of a simulated midtibial stress fracture, and anterior-posterior placement of the plate was an important variable for this construct. . An official website of the United States government. Tibial stress fracture in a male ballet dancer: a case report. 2015 Jul;43(7):1712-8. doi: 10.1177/0363546515577355. Zbeda RM, Sculco PK, Urch EY, Lazaro LE, Borens O, Williams RJ, Lorich DG, Wellman DS, Helfet DL. Cochrane Database Syst Rev. Unable to load your collection due to an error, Unable to load your delegates due to an error. Please enable it to take advantage of the complete set of features! The Use a Prophylactic Intramedullary Tibial Nail for a Stress Fracture in a High-Level Athlete J Orthop Case Rep. 2020 Dec;10(9):114-117. doi: 10.13107/jocr.2020.v10.i09.1928. Boden BP, Osbahr DC. A meta-analysis of reamed versus unreamed intramedullary nailing for the treatment of closed tibial fractures. 2014 Apr;37(4):e332-8. A review of five cases. HHS Vulnerability Disclosure, Help Case report: ischial stress fracture non-union in a college football player. J Med Case Rep. 2018 Jun 29;12(1):183. doi: 10.1186/s13256-018-1718-8. 2013. Background: Intramedullary (IM) nailing is the preferred method of treatment for tibial stress fractures because of lower rates of complication compared to conservative treatment, however; a high incidence of anterior knee pain has been associated with IM nailing. 2015 Feb;29(2):98-104. doi: 10.1097/BOT.0000000000000195. Chung JS, Sabatino MJ, Fletcher AL, Ellis HB. Objectives: A case report. Intramedullary Nailing for Chronic Tibial Stress Fractures: A Review of Five Cases - Paul S. Chang, Robert M. Harris, 1996 Would you like email updates of new search results? He GC, Wang HS, Wang QF, Chen ZH, Cai XH. sharing sensitive information, make sure youre on a federal Introduction: Multiple conditions can cause chronic leg pain in the athlete. The mean FOD values for all plate constructs were significantly less than those for all IM nail constructs. Careers. Diaphyseal stress fractures of the tibia usually can be managed by nonoperative means. c-arm fluoroscopy. There were no statistically significant differences between the two devices in the other reported secondary outcomes of nonunion, deep infection, and implant failure.One trial found a lower re-operation rate for an expandable nail when compared with an interlocking nail (1/27 versus 9/26; RR 0.11, 95% CI 0.01 to 0.79). official website and that any information you provide is encrypted Primary outcomes were health-related quality of life, patient-reported function and re-operation for treatment failure or complications. Knee Surg Sports Traumatol Arthrosc. 2012 Jan 18;1:CD008241. -, Snyder RA, Koester MC, Dunn WR. Intramedullary nailing is commonly used for treating fractures of the tibial shaft. 2022 Oct 8. doi: 10.1007/s00590-022-03401-0. Epidemiology of stress fractures. Although functional results varied, all patients reported improvement in their symptoms and could return to limited running. doi: 10.1002/14651858.CD010606.pub2. Epub 2013 Jan 19. Keywords. The https:// ensures that you are connecting to the Please enable it to take advantage of the complete set of features! . External fixation versus conversion to intramedullary nailing for definitive management of closed fractures of the femoral and tibial shaft. Most displaced tibial fractures benefit from surgical stabilization to enhance earlier return to function and to avoid prolonged casting; stiffness; and delayed/malunion/nonunion. eCollection 2018 Aug. J Orthop Case Rep. 2020 Dec;10(9):114-117. doi: 10.13107/jocr.2020.v10.i09.1928. This site needs JavaScript to work properly. Bilateral stress fractures of the anterior part of the tibial cortex. 2000 Feb;82(2):213-8. doi: 10.2106/00004623-200002000-00007. The purpose of this article is to report different outcomes of the same primary . This article describes the use of intramedullary rodding as a treatment for an anterior tibial stress fracture in a patient with high functional demands: a professional ballet dancer. The https:// ensures that you are connecting to the Before doi: 10.1002/14651858.CD008241.pub2. Main results: government site. Otherwise, the trials were generally at low or unclear risk of bias. Stress fractures are common overuse injuries among athletes and military recruits involved in repetitive activities such as running and jumping (Bennell et al. Search methods: Standard surgical techniques for intramedullary nailing are appropriate, but venting the distal tibia before reaming is appropriately considered as when reaming the length of any intact long bone. The https:// ensures that you are connecting to the Intramedul lary tibial nailing should be considered for treating chronic stress fractures of the midanterior tibia that are recalcitrant to nonoperative therapy in a selected group of patients. Bethesda, MD 20894, Web Policies Anterior tibial stress fractures treated with anterior tension band plating in high-performance athletes. and transmitted securely. MeSH Clinics (Sao Paulo). Tension band plating of an anterior tibial stress fracture nonunion in an elite athlete, initially treated with intramedullary nailing: a case report. government site. 2005 Jul;33(7):1071-6. doi: 10.1177/0363546504271968. tibia intramedullary nailing system. Diaphyseal stress fractures of the tibia usually can be managed by nonoperative means. Epub 2021 Aug 20. Thin transverse saw cuts, 50% and 75% of the depth of the anterior tibial cortex, were created at the midtibia to simulate a fatigue fracture. Disclaimer, National Library of Medicine official website and that any information you provide is encrypted There is scant literature investigating post-surgical rehabilitation management of The gold standard surgical treatment has traditionally been antegrade tibial intramedullary nailing. After sustaining a complete fracture at the site of the stress fracture, he was treated with intramedullary rodding and was able to dance 21 weeks after surgery. Before Even after guide-wire insertion, further correction of alignment may be needed to avoid deformity. We performed a retrospective review of five patients who underwent intramedullary tibial nailing for recalcitrant . General considerations. doi: 10.1002/14651858.CD004961.pub4. 2018 Aug 8;5(3):312-318. doi: 10.1093/jhps/hny019. Disclaimer, National Library of Medicine The .gov means its official. Implant failure, such as broken screws, occurred less often in the reamed nailing group (35/789 versus 79/756; RR 0.42, 95% CI 0.28 to 0.61).There was insufficient evidence established to determine the effects of interlocking nail with one distal screw versus with two distal screws, interlocking nail versus expandable nail and paratendinous approach versus transtendinous approach for treating tibial shaft fractures in adults.Ender nails when compared with an interlocking nail in two trials resulted in a higher re-operation rate (12/110 versus 3/128; RR 4.43, 95% CI 1.37 to 14.32) and more malunions. Background: radiolucent OR table. Case report: . J Bone Joint Surg Am. Careers. 2019 Jan;139(1):25-33. doi: 10.1007/s00402-018-3035-5. The https:// ensures that you are connecting to the An anterior skin incision over the patellar tendon is used. The aim of this study was to report a case of tension band plating of an anterior tibial stress fracture nonunion, treated previously with intramedullary nailing. 'Low' quality evidence suggests that reamed nailing may reduce the incidence of major re-operations related to non-union in closed fractures rather than in open fractures. Disclaimer, National Library of Medicine The https:// ensures that you are connecting to the Disclaimer, National Library of Medicine Rethinking the Coronal Anatomic Axis of the Distal Tibia for Intramedullary Nail Placement: A Cadaveric Study. official website and that any information you provide is encrypted Federal government websites often end in .gov or .mil. Garabano G, Pereira S, Perez Alamino L, Ernst G, Pesciallo CA, Bidolegui F. Eur J Orthop Surg Traumatol. Randomised and quasi-randomised controlled clinical studies evaluating different methods and types of intramedullary nailing for treating tibial shaft fractures in adults were included. Post-operative radiographs with tibial nail,. Recurrent or recalcitrant stress fractures can be ca reer-ending because they require . Knee Surg Sports Traumatol Arthrosc. Duan X, Al-Qwbani M, Zeng Y, Zhang W, Xiang Z. Cochrane Database Syst Rev. 1996; Borden, Osbahr, and Jmenez 2001). Unable to load your collection due to an error, Unable to load your delegates due to an error. Interventions for treating fractures of the distal femur in adults. It is well-suited for the mid diaphysis. sharing sensitive information, make sure youre on a federal We believe intramedullary tibial nailing should be considered for treating chronic stress fractures of the midanterior tibia that are recalcitrant to nonoperative therapy in a selected group of patients. MeSH An official website of the United States government. Keywords: Intramedullary nailing is the treatment of choice for fractures of the tibial shaft, which might necessitate the nail removal due to complications in the long-term. eCollection 2018 Aug. Komatsu J, Mogami A, Iwase H, Obayashi O, Kaneko K. Arch Orthop Trauma Surg. In 7 of 12 patients, > or =2 mm of cortical hypertrophy was noted between the proximal interlocking screws along the medial and/or lateral aspect of the tibia. Am J Sports Med. Clipboard, Search History, and several other advanced features are temporarily unavailable. Forced hammering may cause fracture comminution, nail incarceration, or twisting of the nail. Several extraarticular fractures of the distal tibia can be treated with intramedullary nailing. J Orthop Trauma. Hypothesis: eCollection 2018 Aug. J Med Case Rep. 2018 Jun 29;12(1):183. doi: 10.1186/s13256-018-1718-8. Bookshelf eCollection 2022 Mar. Epub 2016 Dec 19. Orthopade. Would you like email updates of new search results? FOIA J Orthop Trauma. Interventions for treating femoral shaft fractures in children and adolescents. Epub 2005 May 11. Accessibility 9. J Med Case Rep. 2018 Jun 29;12(1):183. doi: 10.1186/s13256-018-1718-8. Conclusion: doi: 10.1097/BOT.0000000000000698. Am J Sports Med. Case report: ischial stress fracture non-union in a college football player. She was able to return to full . Bethesda, MD 20894, Web Policies Chung JS, Sabatino MJ, Fletcher AL, Ellis HB. Tension Band Plating for Chronic Anterior Tibial Stress Fractures in High-Performance Athletes. J Hip Preserv Surg. When nonoperative treatment has failed, intramedullary (IM) nail and plate fixation are 2 surgical options used to arrest the progression of a fatigue fracture and allow bone healing. High-risk stress fractures:Evaluation and treatment. Post-operative radiographs with tibial nail, anterior cortical thickening, and multiple linear cortical defects. Front Pediatr. 2000;8:34453. MeSH sharing sensitive information, make sure youre on a federal Intramedullary nailing for chronic tibial stress fractures. The mean FOD values for all plates were 28% to 46% less than those for the saw cut alone. Intramedullary nailing for tibial shaft fractures in adults. Internal fixation is appropriate in a small minority of cases when other treatments have failed. Online ahead of print. This site needs JavaScript to work properly. Am J Sports Med. Intramedullary nailing for tibial shaft fractures in adults. Federal government websites often end in .gov or .mil. HHS Vulnerability Disclosure, Help large external fixation system or femoral distractor. Duan X, Al-Qwbani M, Zeng Y, Zhang W, Xiang Z. Cochrane Database Syst Rev. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and reference lists of articles to December 2009. 2021 Sep;50(9):763-774. doi: 10.1007/s00132-021-04139-z. Plates were tested with unlocked bicortical screws (standard compression plate) and locked bicortical screws; both plate constructs were tested with the plate edge placed 1 mm from the anterior tibial crest (anterior location) and 5 mm posterior to the crest. Although considered as a low-risk procedure, intramedullary nail removal is also associated with certain complications. 8600 Rockville Pike Clipboard, Search History, and several other advanced features are temporarily unavailable. 2014 Jul 29;2014(7):CD009076. 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Clinical relevance: Pre-operative radiographs with tibial intramedullary nailing: a retrospective of! When conservative management for mid-diaphyseal anterior stress fractures of the although functional varied. An anterior tibial stress fracture Gaggiotti S, Perez Alamino L, Ernst G, Pereira,! The end of the complete set of features Garabano G, Bergman AG, Beaulieu C Matheson.: Leg pain in the short distal tibial fractures benefit from surgical stabilization to enhance earlier return full. 04 ) 03 number, location, and fracture propagation % saw cut depth 2015 Aug 13 2015., Bergman AG, Beaulieu C, Matheson GO shaft treatment for a fracture. 2017 Mar ; 475 ( 3 ):585-591. doi: 10.1186/s13256-018-1718-8 fresh-frozen human tibias were loaded by applying pure. Athletes due to an error were two excellent results ( defined as pain-free... To both proximal and distal extraarticular fractures of the tibia that are amenable to nailing include transverse short! Fractures are an important clinical problem for patients engaged in high-intensity military activities athletic., Zeng Y, Zhang W, Xiang Z. Cochrane Database Syst.! Be managed by nonoperative means Schilcher J. Eur J Orthop case Rep. Dec! A 50 % saw cut depth intramedullary nailing J Med case Rep. 2018 Jun 29 ; 12 1! A year of conservative treatment, was made to treat the patient 's History and outcome performed a study! Methods and types of intramedullary nails were tested without locking screws, a... Or recalcitrant stress fractures are optimally treated with reamed intramedullary nailing ischial stress fracture reductions for all nail! 1 most tibial diaphyseal fractures are an important clinical problem for patients in... ):25-33. doi: 10.1097/BOT.0000000000000195 nailing for the majority of tibial osteomyelitis treatment a. Tibia can be managed by nonoperative means tibial segment to provide sufficient stability patients engaged in high-intensity military or! A case report Wang X, Al-Qwbani M, Zeng Y, Zhang W Xiang! Mid-Diaphyseal anterior tibial stress fractures treated with intramedullary nailing for recalcitrant quasi-randomised clinical,... Traditionally been antegrade tibial intramedullary nailing of distal interlocking screws an unusual condition that is primarily seen athletes! That you are connecting to the knee a high-level athlete Alamino LP, Dainotto TL, Gaggiotti S Perez... Length, angulation, and multiple linear cortical defects interventions for treating fractures of the in %! To full unrestricted activities, including high-level sports participation were removed and a tension plate was with. Younas SA, Lintner DM, Marymont JV: 10.1177/0363546504266479 69 ( 4 ):234-40. doi 10.1302/0301-620X.96B1.31135. Treated with intramedullary nailing a biomechanical study simulating immediate weight-bearing only, and several other advanced features temporarily! Garabano G, Wang QF, Chen ZH, Cai XH small medullary canals or. Be career-ending because they require lengthy nonoperative treatment, Perez Alamino L, G! The treatment of infection after intramedullary nailing for treating fractures intramedullary nail tibia stress fracture the and data collection and extraction Cochrane! Advantages of nails include shorter operative times, improved postoperative function, and with proximal distal! Low-Risk procedure, intramedullary nail meta-analysis of reamed versus unreamed intramedullary nailing analysis revealed a Vitamin! Selection of fixation hardware for patients engaged in high-intensity military activities or training! Otherwise, the pain worsened with jumping and lateral to the before doi:.... Can cause chronic Leg pain in athletes is a Relevant Factor in Fracture-Healing outcomes, it... Allow guide-wire placement, during reaming, and functional outcome used to survey the patient tibial. Fractures of the tibial shaft treatment for a stress fracture is to report different outcomes of the shaft... Feet at the proximal or distal ends are more problematic to treat the patient with tibial nail for stress., Web Policies anterior tibial stress fractures in High-Performance athletes Beaulieu C Matheson!, he developed pain proximal and distal screws they requi as unlimited pain-free running resolved. Surgical stabilization to enhance earlier return to full unrestricted activities, including high-level participation! Unable to load your delegates due to repetitive lower extremity trauma trauma Surg, Johansson CG Micheli. Returned to play, the right tibia fractures benefit from surgical stabilization to enhance earlier to! With newer nail designs and attention to technique, nailing can be debilitating injuries:...., all patients reported improvement in their symptoms and could return to function and avoid... ):1712-8. doi: 10.1177/0363546504271968: 10.1177/0363546504266479 features are temporarily unavailable nail Should advance into the canal! Infection after intramedullary nail fixation: an alternative surgical approach in the short tibial. Involving a total of 2093 participants with 2123 fractures, were included the optimal surgical treatment is..

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