Ricci, J Orthop Trauma 2001 - Fractures of the Proximal Third of the Tibial Shaft Treated with Intramedullary Nails and Blocking Screws - Article Summary

Fractures of the Proximal Third of the Tibial Shaft Treated with Intramedullary Nails and Blocking Screws

Ricci, Sanders, et al.·J Orthop Trauma·2001·196 citations·Prospective cohort

Purpose

To describe the technique and results of using blocking screws and intramedullary nails to treat patients with fractures of the proximal third of the tibial shaft.

Methods

Design: Prospective.

Setting: Level I trauma centers.

Patients: 12 consecutive patients treated with intramedullary nailing and blocking screws for fractures of the proximal third of the tibial shaft.

Intervention: Patients were treated with intramedullary nails and blocking screws.

Main Outcome Measures:

The alignment of fractures was determined using standard anteroposterior and lateral radiographs after surgery and at each follow-up examination.
One patient was lost to follow-up.
All other patients were followed at regular intervals until union or establishment of a nonunion.
Changes in alignment and complications were noted.

Results

Postoperatively, all patients had less than 5 degrees of angular deformity in the planes in which blocking screws were used to control alignment.
One patient had postoperative malalignment (6 degrees of valgus), but a lateral blocking screw to control valgus deformity was not used in this patient.
One patient was lost to follow-up.
11 patients were followed up to union (n = 10) or establishment of a nonunion (n = 1).
10 of 11 patients maintained their postoperative fracture alignment at their last follow-up examination (average follow-up of 33 weeks).
One patient progressed from 6 degrees of valgus immediately after surgery to 10 degrees of valgus at union.
This patient did not have a blocking screw to control valgus angulation.

Conclusions

Blocking screws are effective to help obtain and maintain alignment of fractures of the proximal third of the tibial shaft treated with intramedullary nails.

Supplemental

Fractures of the Proximal Third of the Tibial Shaft Treated with Intramedullary Nails and Blocking Screws.

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Fractures of the Proximal Third of the Tibial Shaft Treated with Intramedullary Nails and Blocking Screws

Ricci, Sanders, et al.·J Orthop Trauma·2001·196 citations·Prospective cohort

DOI·PubMed

Purpose

To describe the technique and results of using blocking screws and intramedullary nails to treat patients with fractures of the proximal third of the tibial shaft.

Methods

Design: Prospective.

Setting: Level I trauma centers.

Patients: 12 consecutive patients treated with intramedullary nailing and blocking screws for fractures of the proximal third of the tibial shaft.

Intervention: Patients were treated with intramedullary nails and blocking screws.

Main Outcome Measures:

The alignment of fractures was determined using standard anteroposterior and lateral radiographs after surgery and at each follow-up examination.
One patient was lost to follow-up.
All other patients were followed at regular intervals until union or establishment of a nonunion.
Changes in alignment and complications were noted.

Results

Postoperatively, all patients had less than 5 degrees of angular deformity in the planes in which blocking screws were used to control alignment.
One patient had postoperative malalignment (6 degrees of valgus), but a lateral blocking screw to control valgus deformity was not used in this patient.
One patient was lost to follow-up.
11 patients were followed up to union (n = 10) or establishment of a nonunion (n = 1).
10 of 11 patients maintained their postoperative fracture alignment at their last follow-up examination (average follow-up of 33 weeks).
One patient progressed from 6 degrees of valgus immediately after surgery to 10 degrees of valgus at union.
This patient did not have a blocking screw to control valgus angulation.

Conclusions

Blocking screws are effective to help obtain and maintain alignment of fractures of the proximal third of the tibial shaft treated with intramedullary nails.

Purpose

To describe the technique and results of using blocking screws and intramedullary nails to treat patients with fractures of the proximal third of the tibial shaft.

Methods

Design: Prospective.

Setting: Level I trauma centers.

Patients: 12 consecutive patients treated with intramedullary nailing and blocking screws for fractures of the proximal third of the tibial shaft.

Intervention: Patients were treated with intramedullary nails and blocking screws.

Main Outcome Measures:

The alignment of fractures was determined using standard anteroposterior and lateral radiographs after surgery and at each follow-up examination.
One patient was lost to follow-up.
All other patients were followed at regular intervals until union or establishment of a nonunion.
Changes in alignment and complications were noted.

Results

Postoperatively, all patients had less than 5 degrees of angular deformity in the planes in which blocking screws were used to control alignment.
One patient had postoperative malalignment (6 degrees of valgus), but a lateral blocking screw to control valgus deformity was not used in this patient.
One patient was lost to follow-up.
11 patients were followed up to union (n = 10) or establishment of a nonunion (n = 1).
10 of 11 patients maintained their postoperative fracture alignment at their last follow-up examination (average follow-up of 33 weeks).
One patient progressed from 6 degrees of valgus immediately after surgery to 10 degrees of valgus at union.
This patient did not have a blocking screw to control valgus angulation.

Conclusions

Blocking screws are effective to help obtain and maintain alignment of fractures of the proximal third of the tibial shaft treated with intramedullary nails.

Purpose

To describe the technique and results of using blocking screws and intramedullary nails to treat patients with fractures of the proximal third of the tibial shaft.

Methods

Design: Prospective.

Setting: Level I trauma centers.

Patients: 12 consecutive patients treated with intramedullary nailing and blocking screws for fractures of the proximal third of the tibial shaft.

Intervention: Patients were treated with intramedullary nails and blocking screws.

Main Outcome Measures:

The alignment of fractures was determined using standard anteroposterior and lateral radiographs after surgery and at each follow-up examination.
One patient was lost to follow-up.
All other patients were followed at regular intervals until union or establishment of a nonunion.
Changes in alignment and complications were noted.

Results

Postoperatively, all patients had less than 5 degrees of angular deformity in the planes in which blocking screws were used to control alignment.
One patient had postoperative malalignment (6 degrees of valgus), but a lateral blocking screw to control valgus deformity was not used in this patient.
One patient was lost to follow-up.
11 patients were followed up to union (n = 10) or establishment of a nonunion (n = 1).
10 of 11 patients maintained their postoperative fracture alignment at their last follow-up examination (average follow-up of 33 weeks).
One patient progressed from 6 degrees of valgus immediately after surgery to 10 degrees of valgus at union.
This patient did not have a blocking screw to control valgus angulation.

Conclusions

Blocking screws are effective to help obtain and maintain alignment of fractures of the proximal third of the tibial shaft treated with intramedullary nails.