title: A newly designed intramedullary nail with distal interlocking system for tibia fractures in adults - the clinical results.
abstract: BACKGROUND
  The surgical treatment of fractures of the tibia includes reamed and unreamed options. Reamed nails have mechanical advantages but they significantly harm the endosteal circulation. Unreamed nails spare the endosteal circulation, but provide a less stable fixation. In both systems, immediate full weight-bearing is not possible due to instability related to distal interlocking (DI). Further, DI is responsible for the majority of the fluoroscopy requirement and a significant loss of surgical time. In our study, we present the clinical results of a new intramedullary (IM) nail and system, which allows stable fixation with an unreamed technique that permits immediate full weight-bearing, with a minimum fluoroscopy requirement for DI.
  
  
  METHODS
  Fifty tibia fractures (49 patients) operated using our new IM system between 2008 and 2010 were evaluated retrospectively. They were allowed full weight-bearing the day after surgery. The patients were followed at least 10 months postoperatively.
  
  
  RESULTS
  Mean fluoroscopy time was 18 seconds (min: 10, max: 30) for DI. Mean union time was 9 weeks (min: 6, max: 12). There was no neurovascular injury, deep infection, malunion, delayed union, or nonunion.
  
  
  CONCLUSIONS
  We demonstrated that our newly developed IM nail and new DI system may be an option to solve the stability problems sourced from the DI screw. It also significantly decreases the requirement of fluoroscopy.
authors.affiliation: Department of Orthopedics and Traumatology, Bezmialem Vakıf University, İstanbul, Turkey. fatihmfk@hotmail.com
authors.forename: Fatih
authors.initials: F
authors.lastname: Küçükdurmaz
authors.forename: Fuat
authors.initials: F
authors.lastname: Akpınar
authors.forename: Gürsel
authors.initials: G
authors.lastname: Saka
authors.forename: Necdet
authors.initials: N
authors.lastname: Sağlam
authors.forename: Cihan
authors.initials: C
authors.lastname: Acı
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails / Q000592:standards* / Q000639:trends; D001863:Bone Screws / Q000592:standards* / Q000639:trends; D002146:Bony Callus / Q000000981:diagnostic imaging; D004867:Equipment Design / Q000592:standards; D005471:Fluoroscopy; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation* / Q000592:standards; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D016474:Weight-Bearing; D055815:Young Adult