title: A novel intramedullary nail for use in the treatment of supramalleolar malunion and nonunion: A preliminary report of three cases.
abstract: BACKGROUND
  The fractures around the supramalleolar region are difficult to manage and deformities may occur following insufficient or inadequate treatment attempts. The treatment of those deformities is even more challenging. The available options for surgical fixation have inherent problems considering the soft tissue problems, infection and compliance of the patients. In this study, we report the preliminary outcome of new IMN system in use of supramalleolar deformities.
  
  
  METHODS
  Three patients with supramalleolar deformities were recruited for this study. Two patients had periarticular distal tibia malunions and one patient had nonunion in same region. All patients were operated with using newly designed intramedullary nail system with a unique distal interlocking bolt screw. The outcome for each patient was followed-up and evaluated with using AOFAS score.
  
  
  RESULTS
  The patients were followed up for 3 years, 3 months, and 6 months, respectively. The AOFAS scores were 36, 33, and 21 preoperatively; and 75, 68, and 75 postoperatively in Patients 1, 2 and 3, respectively.
  
  
  CONCLUSIONS
  In our patient series, adequate fixation following correction of the deformity was seen. Although the number of the cases are limited this study provides encouraging results regarding the outcome of new IMN system in use of supramalleolar deformities.
authors.affiliation: Bezmialem Vakif University, İstanbul, Turkey. Electronic address: fatihmfk@hotmail.com.
authors.forename: Fatih
authors.initials: F
authors.lastname: Küçükdurmaz
authors.affiliation: Umraniye Education and Research Hospital, Turkey.
authors.forename: Necdet
authors.initials: N
authors.lastname: Sağlam
authors.affiliation: Umraniye Education and Research Hospital, Turkey.
authors.forename: Tuhan
authors.initials: T
authors.lastname: Kurtulmuş
authors.affiliation: Istanbul Medeniyet University, Istanbul, Turkey.
authors.forename: Fuat
authors.initials: F
authors.lastname: Akpınar
mesh_terms: D000328:Adult; D001858:Bone Nails; D001863:Bone Screws; D016267:External Fixators; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D017102:Fracture Healing; D017759:Fractures, Malunited / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D011859:Radiography; D012086:Reoperation; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome
keywords: Fracture; Intramedullary nail; Malunion; Supramalleolar; Tibia