The Role of Biplanar Distal Locking in Intramedullary Nailing of Tibial Shaft Fractures

Document Type : RESEARCH PAPER

Authors

1 Ankara Training and Research Hospital, University of Health Sciences, Ankara, Turkey

2 Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey

3 Faculty of Medicine, Muğla Sıtkı Koçman University, Ankara, Turkey

4 Faculty of Medicine, Pamukkale University, Ankara, Turkey

Abstract

Background: To compare the union times of the uncomplicated tibial shaft fractures, which were distally locked by two
coronal and one sagittal screws and by only two coronal screws.
Methods: 45 patients with tibial shaft treated with intramedullary nailing included in this study. 23 of 45 fractures
were treated with uniplanar two distal interlocking (Group 1) and 22 fractures were treated with biplanar three distal
interlocking (Group 2). Patients with closed fractures treated by closed nailing and having a full set of radiographs on
PACS system was included. Fracture unions were evaluated by two authors.
Results: Union time was significantly shorter in biplanar distal interlocking group (Group 2) compared to uniplanar
distal interlocking group (Group 1) (P=0.02). Mean union time in groups 1 and 2 were 14.63±4.5 and 10.77±3.0
weeks, respectively .When only distal third tibial shaft fractures were evaluated, Group 2 [11.2±3.1 weeks (n:17)] had
significantly lower union time compared to Group 1 [15.07±4.8 weeks (n:14)] (P=0.01). Inter-observer reliability for
fracture union times was high with rho= 0.89 with SE of 0.51 (P<0.001).
Conclusion: Biplanar distal interlocking procedure had a significantly shorter union time. Biplanar distal interlocking
procedure allows a faster fracture union probably because of a more stable fixation construct.

Keywords

Main Subjects

References

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The Archives of Bone and Joint Surgery
Volume 7, Issue 1
January and February 2019
Pages 33-37

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History

  • Receive Date: 29 September 2016
  • Revise Date: 12 March 2017
  • Accept Date: 11 November 2017

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