Effects of intramedullary nail removal after tibial fracture repair: A prospective study
Journal Title: International Journal of Orthopaedics Sciences - Year 2018, Vol 4, Issue 1
Abstract
Introduction: Tibial fractures are the most common long bone fracture. The standard of care for the treatment of diaphyseal tibial fractures is an intramedullary nail (IMN). Implant removal is one of the most common procedures in bone and joint surgery, and criteria for implant removal are typically left to the treating surgeon. We conducted a prospective study to investigate effects of intramedullary nail removal after tibial fracture union. Methods: Sixty patients at our hospital were enrolled in a prospective study and divided into moderate/severe knee pain (visual analog scale (VAS) - 4) and mild/no knee pain (VAS < 4) groups after interlocking intramedullary nailing. Variables studied included the distance from the tip of the nail to the tibial plateau and the front of the tibia on a normalized lateral X-ray, the VAS score of knee and ankle pain, the range of motion of the knee and ankle, and Johner–Wruhs criteria before, 6 weeks after operation, and at the last follow-up. Results: Fifty-seven patients were followed for a mean of 8.4 (2–17) months. In patients with moderate or severe knee pain intramedullary nail removal led to significant pain reductions (p < 0.05). A significantly shorter distance from the tip of the nail to the tibial plateau (<10 mm) and the anterior border of tibia (<6 mm) was found in the 24 patients with moderate or severe knee pain. Conclusion: For patients complaining knee pain after interlocking intramedullary nailing of tibial fractures, especially with a short distance from the tip of the nail tail to the tibial plateau(<10 mm) and the anterior border of the tibia (<6 mm) removal of the intramedullary nails relieved the pain significantly.
Authors and Affiliations
Misbah Mehraj, Iqra Shah
Keywords
Related Articles
- EP ID EP485741
- DOI 10.22271/ortho.2018.v4.i1m.128
- Views 112
- Downloads 0
Functional outcome of modified Boytchev procedure in recurrent shoulder dislocation
Objective: To evaluate functional outcome of recurrent anterior shoulder dislocation by modified Boytchev procedure. Materials and Method: This prospective study was done in 30 patients with recurrent dislocation of the...
A study on segments of humerus and its clinical importance
Background: The humerus is the both the largest bone in the arm and the only bone in the upper arm. Many powerful muscles that manipulate the upper arm at the shoulder and the forearm at the elbow are anchored to the hum...
The role of proximal fibular osteotomy in the management of medial compartment osteoarthritis of the knee
Background:Young active patients with isolated medial compartment arthritis of the knee are not ideal candidates for Total knee arthroplasty. Hence there is a need for a procedure which would be ideally suited for the sa...
Bilateral traumatic dislocation of the elbow in a case and review of the literature
We report a case of bilateral dislocation of the elbow in a 53 year-old patient. This trauma condition is rare and no often discussed in the literature. It was treated orthopedically 24 hours after the trauma occurred. T...
Radiological evaluation of distal radio-ulnar joint congruency in distal radius fractures
Distal Radius fractures (DRFs) are recognized as complex injuries with prognosis depending on several variables which include the fracture type and the method of treatment. Some mal-alignment of the distal Radio-Ulnar an...