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Accepted (AM)Open Access (License Unspecified), Open
Journal article
A Critical Analysis of Lateral Versus Central Endpoint in Distal Tibia Nailing: Does It Affect Alignment?
JOURNAL OF ORTHOPAEDIC TRAUMA, v 36(8), p400
Aug 2022
PMID: 34999627
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objectives: To evaluate the effect of a traditional center-center end point for distal tibia nailing in comparison with a lateral-of-center end point on fracture malalignment in a cadaver model. Methods: Nine matched pairs of human cadaveric lower-extremity specimens were used to model the effect of nail end point on fracture alignment in extra-articular distal tibia fractures. After simulation of the fracture through a standardized osteotomy, 1 member of each pair was fixed with an intramedullary nail using a center-center end point, whereas a lateral-of-center end point was used for the other member of the pair. Specimens were stripped of soft tissue, and digital calipers were used to measure fracture translation and gap medially, laterally, anteriorly, and posteriorly. Coronal plane angulation at each fracture was measured on the final mortise image. Results: The average coronal angulation was 7.0 degrees of valgus (with a SD of 4.1) in central-end point specimens versus 0.2 degrees of valgus (SD = 1.5) in lateral-end point specimens (P < 0.001). Lateral-end point specimens also demonstrated significantly less fracture gap medially (mean 0.2 vs. 3.1 mm for central-end point specimens, P < 0.001), anteriorly (mean 0.1 vs. 1.3 mm, P = 0.003), and posteriorly (mean 0.3 vs. 2.2 mm, P = 0.003). Lateral-end point specimens also showed less lateral translation (mean 0.6 vs. 1.6 mm, P = 0.006). Conclusions: Lateral-of-center nail end points may help surgeons restore native alignment in extra-articular distal tibia fractures and avoid valgus malalignment.
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Details
- Title
- A Critical Analysis of Lateral Versus Central Endpoint in Distal Tibia Nailing: Does It Affect Alignment?
- Publication Details
- JOURNAL OF ORTHOPAEDIC TRAUMA, v 36(8), p400
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS; PHILADELPHIA
- Grant note
- This work was funded by Globus Medical, Inc., Audubon, PA.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Drexel University
- Web of Science ID
- WOS:000825571900014
- Scopus ID
- 2-s2.0-85134632186
- Other Identifier
- 991021861302904721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Orthopedics
- Sport Sciences