title: A tip to reduce the malrotation of the spiral tibial fracture intraoperatively.
abstract: BACKGROUND
  Tibial spiral fractures treated by closed intramedullary (IM) nailing are at risk for malrotational deformities. The purpose of this study was to examine a method to minimize the risk of tibial malrotation during closed IM nailing of spiral tibial fractures.
  
  
  METHODS
  This trial is done through 24 patients of spiral tibial fractures with a mean age of 38.5 years (range 26-63 years). The patients were divided into two groups. One group the fractures were reduced by rotating the distal locked nail to obtain rotational alignment and another group by the standard assistant rotated technique. All the patients were evaluated with CT scans postoperatively. The parameters such as rotational values, operative and radiation exposure time were recorded and compared between two groups. Mann-Whitney test was used to test the significance of these parameters.
  
  
  RESULTS
  The group using the tip had a smaller mean rotational value, which was (6.8° ± 2.1° vs. 11.8° ± 5.2°; P < 0.01). The mean operative time was not statistically different (70.6 ± 4.4 vs. 63.0 ± 2.9 min; P > 0.05), so did the mean radiation exposure time (48.1 ± 4.2 vs. 42.6 ± 4.8 s; P > 0.05).
  
  
  CONCLUSIONS
  The described technique of rotating the nail after initial distal interlocking can correct rotational abnormalities in spiral tibial shaft fractures in the premise of not increasing the operative and radiation exposure times statistically.
authors.affiliation: Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, China.
authors.forename: Jialiang
authors.initials: J
authors.lastname: Guo
authors.forename: Yingze
authors.initials: Y
authors.lastname: Zhang
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Hou
authors.forename: Zengyan
authors.initials: Z
authors.lastname: Li
mesh_terms: D000328:Adult; D001858:Bone Nails; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012399:Rotation; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*