Retrospective series of 32 extraarticular proximal third tibial shaft fractures treated with locked intramedullary nailing at a single institution (1989–1994). The study asks whether intramedullary nailing reliably achieves and maintains acceptable alignment in this specific fracture location.
When you encounter a proximal third tibial shaft fracture, recognize that standard IMN technique carries an ~84% malalignment rate — before nailing, confirm you can place two proximal interlocking screws and use a central (not medial) entry point with an insertion angle parallel to the anterior cortex; if two proximal screws are not achievable, strongly consider plate fixation (closed fractures) or external fixation (open fractures) instead.
Retrospective series of 32 extraarticular proximal third tibial shaft fractures treated with locked intramedullary nailing at a single institution (1989–1994). The study asks whether intramedullary nailing reliably achieves and maintains acceptable alignment in this specific fracture location.
When you encounter a proximal third tibial shaft fracture, recognize that standard IMN technique carries an ~84% malalignment rate — before nailing, confirm you can place two proximal interlocking screws and use a central (not medial) entry point with an insertion angle parallel to the anterior cortex; if two proximal screws are not achievable, strongly consider plate fixation (closed fractures) or external fixation (open fractures) instead.