title: Removal of interlocking intramedullary nail for relieve of knee pain after tibial fracture repair.
abstract: To investigate the effects of intramedullary nail removal after tibial fracture repair.
  
  
  
  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.
  
  
  
  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. Knee pain VAS scores significantly lowered 6 weeks postoperatively and at the last follow-up, compared to before the operation ( p < 0.05). However, no significant changes occurred with respect to ankle pain VAS scores, range of motion, and Johner-Wruhs criteria ( p > 0.05).
  
  
  
  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.affiliation: Department of Orthopedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
authors.forename: Shaodong
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of Orthopedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
authors.forename: Xiaotao
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Orthopedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Orthopedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Wang
mesh_terms: D000328:Adult; D000843:Ankle Joint; D018771:Arthralgia / Q000209:etiology / Q000601:surgery*; D001858:Bone Nails / Q000009:adverse effects*; D020878:Device Removal; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D007719:Knee Joint; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology / Q000601:surgery*; D011446:Prospective Studies; D016059:Range of Motion, Articular; D013978:Tibial Fractures / Q000601:surgery*; D014945:Wound Healing
keywords: VAS scores; distal tibial fracture; interlocking intramedullary nail; knee pain; tibia fracture