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Original Research| Volume 56, ISSUE 6, P1232-1235, November 2017

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Expert Tibial Nails for Treating Distal Tibial Fractures With Soft Tissue Damage: A Patient Series

Published:September 07, 2017DOI:https://doi.org/10.1053/j.jfas.2017.07.011

      Abstract

      Distal tibial fractures with soft tissue damage are relatively difficult to treat. We assessed the outcomes of patients with these fractures treated with the Expert Tibial Nail® (DePuy Synthes, Raynham, MA) from March 2012 to December 2014. At 6 months postoperatively, the general health quality of patients was assessed using operative time, interval to return to work, American Orthopaedic Foot and Ankle Society ankle scale score, pain measured using a visual analog scale, and short-form health outcomes 36-item survey physical functioning and mental health dimension scores. Of 11 cases, 7 (63.6%) were open fractures (3 [27.3%] Gustilo-Anderson type II, 3 [27.3%] type IIIA, and 1 [9.1%] type IIIB) and 4 (36.4%) were closed fractures with Tscherne-Oestern type II tissue damage. Their mean age was 52.2 (range 28 to 66) years. The mean operative time was 83 (range 65 to 105) minutes. The mean follow-up period was 16.3 (range 14 to 18) months. The median short-form 36-item survey scores were 79.1 (range 68.9 to 89.0) for the physical function dimension and 77.0 (range 64.3 to 90.0) for the mental health dimension. The mean postoperative ankle score was 88.6 (range 84 to 94). The mean pain score was 1.6 (range 0 to 4) mm. The mean interval to return to work was 14 (range 11 to 17) months. No patient showed evidence of neurovascular damage, malunion, nonunion, or shortening of the tibia. Taken together, we have confirmed that Expert Tibial Nails can effectively treat distal tibial fractures with soft tissue damage.

      Level of Clinical Evidence

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      References

        • Dong Q.
        • Hong D.Y.
        • Park Y.W.
        • Kim H.N.
        Elastic bandage traction technique for reduction of distal tibial fractures.
        J Foot Ankle Surg. 2015; 54: 949-952
        • Jiamton C.
        • Apivatthakakul T.
        The safety and feasibility of minimally invasive plate osteosynthesis (MIPO) on the medial side of the femur: a cadaveric injection study.
        Injury. 2015; 46: 2170-2176
        • Ceroni D.
        • Grumetz C.
        • Desvachez O.
        • Pusateri S.
        • Dunand P.
        • Samara E.
        From prevention of pin-tract infection to treatment of osteomyelitis during paediatric external fixation.
        J Child Orthop. 2016; 10: 605-612
        • Pairon P.
        • Ossendorf C.
        • Kuhn S.
        • Hofmann A.
        • Rommens P.M.
        Intramedullary nailing after external fixation of the femur and tibia: a review of advantages and limits.
        Eur J Trauma Emerg Surg. 2015; 41: 25-38
        • Tadros A.M.
        • Elhelw A.M.
        • Eldehi M.
        • Al-Shaeel R.A.
        Removal of a femoral intramedullary nail with impacted nail end cap using a broken screw extraction set: a case report and literature review.
        Acta Orthop Traumatol Turc. 2015; 49: 217-219
        • Japjec M.
        • Staresinić M.
        • Culjak V.
        • Vrgoc G.
        • Sebecić B.
        The role of external fixation in displaced pilon fractures of distal tibia.
        Acta Clin Croat. 2013; 52: 478-484
        • Lee K.J.
        • Min B.W.
        • Jung J.H.
        • Kang M.K.
        • Kim M.J.
        Expert tibia nail for subtrochanteric femoral fracture to prevent thermal injury.
        Int J Surg Case Rep. 2015; 10: 158-161
        • Attal R.
        • Hansen M.
        • Kirjavainen M.
        • Bail H.
        • Hammer T.O.
        • Rosenberger R.
        • Höntzsch D.
        • Rommens P.M.
        A multicentre case series of tibia fractures treated with the expert tibia nail (ETN).
        Arch Orthop Trauma Surg. 2012; 132: 975-984
        • Kitaoka H.B.
        • Alexander I.J.
        • Adelaar R.S.
        • Nunley J.A.
        • Myerson M.S.
        • Sanders M.
        Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes.
        Foot Ankle Int. 1994; 15: 349-353
        • Irahim T.
        • Beiri A.
        • Azzabi M.
        • Best A.J.
        • Taylor G.J.
        • Menon D.K.
        Reliability and validity of the subjective component of the American Orthopaedic Foot and Ankle Society clinical rating scales.
        J Foot Ankle Surg. 2007; 46: 65-74
        • Gustilo R.B.
        • Anderson J.T.
        The prevention of infection in treatment of 1000 and 25 open fractures of long bones-retrospective and prospective analysis.
        J Bone Joint Surg Am. 1976; 58: 453-458
        • Oestern H.J.
        • Tscherne H.
        Pathophysiology and classification of soft tissue injuries associated with fractures.
        in: Tscherne H. Gotzen L. Fractures with Soft Tissue Injuries. Springer-Verlag, Berlin1984: 1-9
        • Beytemür O.
        • Barış A.
        • Albay C.
        • Yüksel S.
        • Çağlar S.
        • Alagöz E.
        Comparison of intramedullary nailing and minimal invasive plate osteosynthesis in the treatment of simple intra-articular fractures of the distal tibia (AO-OTA type 43 C1-C2).
        Acta Orthop Traumatol Turc. 2017; 51: 12-16
        • Windhager R.
        • Schreiner M.
        • Staats K.
        • Apprich S.
        Megaprostheses in the treatment of periprosthetic fractures of the knee joint: indication, technique, results and review of literature.
        Int Orthop. 2016; 40: 935-943
        • Zhou Y.
        • Wang Y.
        • Liu L.
        • Zhou Z.
        • Cao X.
        Locking compression plate as an external fixator in the treatment of closed distal tibial fractures.
        Int Orthop. 2015; 39: 2227-2237
        • Ebraheim N.A.
        • Evans B.
        • Liu X.
        • Tanios M.
        • Gillette M.
        • Liu J.
        Comparison of intramedullary nail, plate, and external fixation in the treatment of distal tibia nonunions.
        Int Orthop. 2017; 41: 1925-1934
        • Ebraheim N.A.
        • Ludwig T.
        • Weston J.T.
        • Carroll T.
        • Liu J.
        Comparison of surgical techniques of 111 medial malleolar fractures classified by fracture geometry.
        Foot Ankle Int. 2014; 35: 471-477
        • Ebrahimzadeh M.H.
        • Birjandinejad A.
        • Moradi A.
        • Fathi Choghadeh M.
        • Rezazadeh J.
        • Omidi-Kashani F.
        Clinical instability of the knee and functional differences following tibial plateau fractures versus distal femoral fractures.
        Trauma Mon. 2015; 20: e21635
        • Chen D.W.
        • Li B.
        • Aubeeluck A.
        • Yang Y.F.
        • Zhou J.Q.
        • Yu G.R.
        Open reduction and internal fixation of posterior pilon fractures with buttress plate.
        Acta Ortop Bras. 2014; 22: 48-53