The nail-insertion point in unreamed tibial nailing and its influence on the axial malalignment in proximal tibial fractures.
The consequence of choosing a point of insertion for the nail (i.e. medial or lateral of the lig. patellae) in unreamed tibial nailing (AO unreamed tibial nail, UTN) was studied in 22 formaldhyde-fixed tibiae. A lateral osteotomy at the transition from the first to the second fifth of the tibia was used as a model for the fracture. A nail insertion point medial of the lig. patellae caused a valgus deformity, combined with a shift of the distal fragment to the medial side. A lateral point of entry resulted in a varus deformity, together with a lateral shift of the distal fragment. Our results show that the insertion point of the nail is important for the alignment of the axis. Choosing a different point for the insertion of the nail can be useful in operative correction of malalignment of the tibia.
Lembcke
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Second Department of Orthopaedic Surgery, Hessingklinik, Hessingstrasse 17, 86199 Augsburg, Germany. o.lembcke@augsburg.baynet.de
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Beck
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D001696:Biomechanical Phenomena; D017760:Bone Malalignment / Q000503:physiopathology*; D001858:Bone Nails; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D006801:Humans; D007718:Knee Injuries / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000503:physiopathology*; D013978:Tibial Fractures / Q000503:physiopathology / Q000601:surgery*