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