An official website of the United States government. -, Varner KE, Younas SA, Lintner DM, Marymont JV. Primary outcomes were health-related quality of life, patient-reported function and re-operation for treatment failure or complications. Please enable it to take advantage of the complete set of features! Hypothesis: The use of a reamed intramedullary nail for a chronic anterior tibial stress fracture is a safe and effective treatment for an athlete. HSS J. Both quasi-randomised trials were at high risk of selection bias. Bookshelf Rethinking the Coronal Anatomic Axis of the Distal Tibia for Intramedullary Nail Placement: A Cadaveric Study. Am J Sports Med. : "The Effect of Social Deprivation on Fracture-Healing and Patient-Reported Outcomes Following Intramedullary Nailing of Tibial Shaft Fractures" Our case report specifically describes a case of a high-level athlete with multiple anterior tibial linear cortical defects from a chronic stress fracture. Intramedullary Nail and Plate Combination Fixation for Complex Distal Tibia Fractures: When and How? Intramedul lary tibial nailing should be considered for treating chronic stress fractures of the midanterior tibia that are recalcitrant to nonoperative therapy in a selected group of patients. The role of prophylactic intramedullary nailing in this difficult fracture is discussed. official website and that any information you provide is encrypted There were two excellent results (defined as unlimited pain-free running and resolved tibial pain) and three good results. J Orthop Trauma. 2015 Jul;43(7):1712-8. doi: 10.1177/0363546515577355. Intramedullary nailing for tibial shaft fractures in adults. When nonoperative treatm. The appearance of the "dreaded black line" is indicative of nonunion, an indication for surgery.11, 17 There are 2 surgical treatment options to treat anterior tibial stress fractures, namely, intramedullary nail or anterior tibial plating. 2012 Jan 18;1:CD008241. Keywords: Stress fractures are common overuse injuries among athletes and military recruits involved in repetitive activities such as running and jumping (Bennell et al. FOIA With newer nail designs and attention to technique, nailing can be extended to both proximal and distal extraarticular fractures. The site is secure. 2014;69(4):234-40. doi: 10.6061/clinics/2014(04)03. . Brukner P, Fanton G, Bergman AG, Beaulieu C, Matheson GO. Several extraarticular fractures of the distal tibia can be treated with intramedullary nailing. Accessibility Background: Intramedullary nailing is commonly used for treating fractures of the tibial shaft. 1996; Borden, Osbahr, and Jmenez 2001). Zha J, Zhang G, Wang X, Li J, Di J, Guo J. Ther Clin Risk Manag. PMC 2019 Oct 4;7:397. doi: 10.3389/fped.2019.00397. Accessibility Although considered as a low-risk procedure, intramedullary nail removal is also associated with certain complications. -. Two-year post-operative radiographs with tibial nail, anterior cortical thickening, and resolution. The search was subsequently updated to September 2011 to assess the more recent literature. Randomised and quasi-randomised controlled clinical studies evaluating different methods and types of intramedullary nailing for treating tibial shaft fractures in adults were included. Epub 2016 Dec 19. Intramedullary nailing is commonly used for treating fractures of the tibial shaft. Introduction: government site. Equipment. J Orthop Case Rep. 2020 Dec;10(9):114-117. doi: 10.13107/jocr.2020.v10.i09.1928. Unable to load your collection due to an error, Unable to load your delegates due to an error. 2013. J Hip Preserv Surg. However, the right tibia subsequently developed nonunion. c-arm fluoroscopy. Before Exclusion criteria included open fractures, fibular fractures in the context of distal tibia or pilon fractures, previous ipsilateral or contralateral ankle fractures, neuroarthropathy . 8600 Rockville Pike Plate fixation was superior to IM nail fixation in limiting the opening of a simulated midtibial stress fracture, and anterior-posterior placement of the plate was an important variable for this construct. Chronic anterior midtibial stress fractures in athletes treated with reamed intramedullary nailing. Thin transverse saw cuts, 50% and 75% of the depth of the anterior tibial cortex, were created at the midtibia to simulate a fatigue fracture. Results from these tests can help guide the selection of fixation hardware for patients requiring surgical treatment for a midtibial stress fracture. Plates were tested with unlocked bicortical screws (standard compression plate) and locked bicortical screws; both plate constructs were tested with the plate edge placed 1 mm from the anterior tibial crest (anterior location) and 5 mm posterior to the crest. Intramedullary nails; Upper limb and transmitted securely. External fixation versus conversion to intramedullary nailing for definitive management of closed fractures of the femoral and tibial shaft. official website and that any information you provide is encrypted While inconclusive, the evidence from a subgroup analysis suggests that reamed nailing is more likely to reduce the incidence of major re-operations related to non-union in closed fractures than in open fractures. doi: 10.1002/14651858.CD010606.pub2. Aneja A, Marquez-Lara A, Luo TD, Teasdall RJ, Isla A, Albano A, Halvorson JJ, Carroll EA. Disclaimer, National Library of Medicine Background:Anterior midtibial stress fractures are an important clinical problem for patients engaged in high-intensity military activities or athletic training activities. government site. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and reference lists of articles to December 2009. Reduction is an essential part of intramedullary nailing. FOIA optional: large sharp periarticular clamps or Weber-style clamps. Conclusion: Before MeSH MeSH Careers. The https:// ensures that you are connecting to the An official website of the United States government. official website and that any information you provide is encrypted Epub 2015 Mar 31. J Orthop Trauma. The purpose of our study was to highlight a case of an athlete sustaining a tibial stress fracture with multiple cortical defects. Contraindications to intramedullary nailing include immature patients. PMC Bookshelf Post-operative radiographs with tibial nail, anterior cortical thickening, and multiple linear cortical defects. Two weeks after surgery, he developed pain proximal and lateral to the knee. 2021 Sep 20;56(3):386-391. doi: 10.1007/s43465-021-00523-1. Selection criteria: 2019 Oct 4;7:397. doi: 10.3389/fped.2019.00397. Orthopedics. Unable to load your collection due to an error, Unable to load your delegates due to an error. 9. Intramedullary nailing usually represents a relatively drastic step in the management of stress fracture, and the diagnosis of tibial stress fracture must be definitively confirmed before it is contemplated, which is not as trivial as it might seem. J Med Case Rep. 2018 Jun 29;12(1):183. doi: 10.1186/s13256-018-1718-8. Bethesda, MD 20894, Web Policies FOIA This article describes the use of intramedullary rodding as a treatment for an anterior tibial stress fracture in a patient with high functional demands: a professional ballet dancer. are associated with an increased risk of fracture malreduction. Conclusion: Chronic tibial stress fracture is an unusual condition that is primarily seen in athletes and military personnel. 'Moderate' quality evidence suggests that there is no clear difference in the rate of major re-operations and complications between reamed and unreamed intramedullary nailing. Clin Sports Med. sharing sensitive information, make sure youre on a federal Duan X, Al-Qwbani M, Zeng Y, Zhang W, Xiang Z. Cochrane Database Syst Rev. 2018 Aug 8;5(3):312-318. doi: 10.1093/jhps/hny019. The .gov means its official. The gold standard surgical treatment has traditionally been antegrade tibial intramedullary nailing. These fracture patterns have been treated in the past either with closed reduction and casting/bracing or with open reduction internal fixation using plates. J Med Case Rep. 2018 Jun 29;12(1):183. doi: 10.1186/s13256-018-1718-8. Disclaimer, National Library of Medicine There were very few data on functional outcomes; and often incomplete data on re-operations. Clinics (Sao Paulo). eCollection 2022. Intramedullary nailing. Most displaced tibial fractures benefit from surgical stabilization to enhance earlier return to function and to avoid prolonged casting; stiffness; and delayed/malunion/nonunion. Summary: Tibial shaft fractures distal to total knee arthroplasty are rare, but they are likely to become more common with the increasing number of arthroplasty procedures being performed. Chan DS, Nayak AN, Blaisdell G, James CR, Denard A, Miles J, Santoni BG. eCollection 2019. See this image and copyright information in PMC. Anterior tibial stress fractures treated with anterior tension band plating in high-performance athletes. HHS Vulnerability Disclosure, Help 8600 Rockville Pike When nonoperative treatment has failed, intramedullary (IM) nail and plate fixation are 2 surgical options used to arrest the progression of a fatigue fracture and allow bone healing. Each patient had an unusually narrow medullary canal, a thickened anterior cortex, and a linear unicortical fracture line on the anterior or tension side. J Med Case Rep. 2018 Jun 29;12(1):183. doi: 10.1186/s13256-018-1718-8. When . The effect of concurrent fibular fracture on the fixation of distal tibia fractures: a laboratory comparison of intramedullary nails with locked plates. 2006;14(10 Spec No.):S131-5. 2005 Jan;33(1):124-30. doi: 10.1177/0363546504266479. doi: 10.1002/14651858.CD008241.pub2. and transmitted securely. A plate will be more effective than an IM nail in preventing the opening of a simulated anterior midtibial stress fracture from tibial bending. Would you like email updates of new search results? Recurrent or recalcitrant stress fractures can be ca reer-ending because they require . 2014 Dec;9(4):753-826. doi: 10.1002/ebch.1987. Lateral fixation: an alternative surgical approach in the prevention of complete atypical femoral fractures. Intramedullary Nailing for Chronic Tibial Stress Fractures: A Review of Five Cases - Paul S. Chang, Robert M. Harris, 1996 government site. Fractures located in the middle two thirds of the tibia that are amenable to nailing include transverse, short oblique, spiral . The https:// ensures that you are connecting to the Orthopade. official website and that any information you provide is encrypted 2006;25:3752. Epub 2021 Aug 20. In 7 of 12 patients, > or =2 mm of cortical hypertrophy was noted between the proximal interlocking screws along the medial and/or lateral aspect of the tibia. Main results: HHS Vulnerability Disclosure, Help 1-7 However, up to 79% of patients need complementary procedures for certain complications. Varner KE, Younas SA, Lintner DM, Marymont JV. Bookshelf Intramedullary nailing of the tibia for chronic stress fracture has a high union rate, allows for a low complication rate, and allows for an early return to competitive sports. An extensometer spanning the defect was used to measure the fracture opening displacement (FOD) before and after the application of IM nail and plate fixation constructs. A complete posterior tibial stress fracture that occurred during a middle-distance running race: a case report. 2013 Jun;21(6):1447-50. doi: 10.1007/s00167-013-2365-7. An official website of the United States government. Bookshelf Federal government websites often end in .gov or .mil. They have been described occurring in athletes due to repetitive lower extremity trauma. 2016 Nov;30 Suppl 4:S17-S21. Bethesda, MD 20894, Web Policies eCollection 2022 Mar. General considerations. Nailing in fractures of the upper limb has evolved a long way, but has not paralleled the impact it has made in fractures of the lower limb. Results: Chung JS, Sabatino MJ, Fletcher AL, Ellis HB. Background: Anterior midtibial stress fractures are an important clinical problem for patients engaged in high-intensity military activities or athletic training activities. Implant failure, such as broken screws, occurred less often in the reamed nailing group (35/789 versus 79/756; RR 0.42, 95% CI 0.28 to 0.61).There was insufficient evidence established to determine the effects of interlocking nail with one distal screw versus with two distal screws, interlocking nail versus expandable nail and paratendinous approach versus transtendinous approach for treating tibial shaft fractures in adults.Ender nails when compared with an interlocking nail in two trials resulted in a higher re-operation rate (12/110 versus 3/128; RR 4.43, 95% CI 1.37 to 14.32) and more malunions. 2021 Sep;50(9):763-774. doi: 10.1007/s00132-021-04139-z. Background: A chronic anterior midtibial stress fracture is a serious, difficult-to-treat injury that can adversely affect an athlete's career. 2018 Aug 8;5(3):312-318. doi: 10.1093/jhps/hny019. The Use a Prophylactic Intramedullary Tibial Nail for a Stress Fracture in a High-Level Athlete. 2017 Mar;475(3):585-591. doi: 10.1007/s11999-016-5202-8. HHS Vulnerability Disclosure, Help 'Low' quality evidence suggests that reamed nailing may reduce the incidence of major re-operations related to non-union in closed fractures rather than in open fractures. Bethesda, MD 20894, Web Policies We performed a retrospective review of five patients who underwent intramedullary tibial nailing for recalcitrant . Varner KE, Younas SA, Lintner DM, Marymont JV. doi: 10.1002/14651858.CD008241.pub2. The nail design determines the number, location, and orientation of distal interlocking screws. Tension Band Plating for Chronic Anterior Tibial Stress Fractures in High-Performance Athletes. Mid-diaphyseal anterior tibial stress fractures can be debilitating injuries. Am J Sports Med. Length, angulation, and rotation are all important to restore. 2000 Feb;82(2):213-8. doi: 10.2106/00004623-200002000-00007. Anterior tibial stress fracture treated with intramedullary nailing: a case report Clin J Sport Med. The Use a Prophylactic Intramedullary Tibial Nail for a Stress Fracture in a High-Level Athlete J Orthop Case Rep. 2020 Dec;10(9):114-117. doi: 10.13107/jocr.2020.v10.i09.1928. sharing sensitive information, make sure youre on a federal 1995;5(1):58-61; discussion 61-2. doi: 10.1097/00042752 . Am J Sports Med. Effect of distal interlocking screw number and position after intramedullary nailing of distal tibial fractures: a biomechanical study simulating immediate weight-bearing. MeSH Objectives: This site needs JavaScript to work properly. Overall, there is insufficient evidence to draw definitive conclusions on the best type of, or technique for, intramedullary nailing for tibial shaft fractures in adults. Recurrent or recalcitrant stress fractures can be career-ending because they require lengthy nonoperative treatment. Concurrent Bilateral Anterior Tibial Stress Fractures and Vitamin D Deficiency in an Adolescent Female Athlete: Treatment With Early Surgical Intervention. Hypothesis: MeSH INTRODUCTION. 8600 Rockville Pike Standard surgical techniques for intramedullary nailing are appropriate, but venting the distal tibia before reaming is appropriately considered as when reaming the length of any intact long bone. The relevance of the number of distal locking planes and nail to canal ratio in bone healing after intramedullary nailing in tibial shaft fractures. As he returned to play, the pain worsened with jumping and lateral movement and improved with rest. . Epub 2021 Apr 15. Tension band plating of an anterior tibial stress fracture nonunion in an elite athlete, initially treated with intramedullary nailing: a case report. J Orthop Case Rep. 2020 Dec;10(9):114-117. doi: 10.13107/jocr.2020.v10.i09.1928. large external fixation system or femoral distractor. Pekmezci M, McDonald E, Buckley J, Kandemir U. Keywords. 2015 Jul;43(7):1712-8. doi: 10.1177/0363546515577355. Epub 2015 Mar 31. We report the case of a 28-year-old male semiprofessional basketball player who presented to an outside hospital with nonhealing stress fractures for which he underwent tibial intramedullary nailing (IMN). Before Diaphyseal stress fractures of the tibia usually can be managed by nonoperative means. He GC, Wang HS, Wang QF, Chen ZH, Cai XH. and transmitted securely. Please enable it to take advantage of the complete set of features! Disclaimer, National Library of Medicine 2005 Jul;33(7):1071-6. doi: 10.1177/0363546504271968. Diaphyseal stress fractures of the tibia usually can be managed by nonoperative means. Unable to load your collection due to an error, Unable to load your delegates due to an error. Epub 2018 Sep 7. Bone Joint J. Would you like email updates of new search results? 2022 Sep 23;18:945-954. doi: 10.2147/TCRM.S379135. The https:// ensures that you are connecting to the She was able to return to full . HHS Vulnerability Disclosure, Help Before Please enable it to take advantage of the complete set of features! Case report: ischial stress fracture non-union in a college football player. J Orthop Case Rep. 2014 Jan-Mar;4(1):39-43. doi: 10.13107/jocr.2250-0685.147. Am J Sports Med. The osteosynthesis of a tibial diaphyseal fracture with a locked intramedullary nail (LIN) is recommended by various authors due to the high union rates, low infection and deformity rates, and good functional results. doi: 10.3928/01477447-20140401-52. There were no statistically significant differences between the two devices in the other reported secondary outcomes of nonunion, deep infection, and implant failure.One trial found a lower re-operation rate for an expandable nail when compared with an interlocking nail (1/27 versus 9/26; RR 0.11, 95% CI 0.01 to 0.79). Plate fixation was superior to IM nail fixation in limiting the opening of a simulated midtibial stress fracture, and anterior-posterior placement of the plate was an important variable for this construct. Hypothesis: A plate will be more effective than an IM nail in preventing the opening of a simulated anterior midtibial stress fracture from tibial bending. 1995;5:5861. An official website of the United States government. Case report: Interventions for treating femoral shaft fractures in children and adolescents. doi: 10.1002/14651858.CD004961.pub4. Before Advantages of nails include shorter operative times, improved postoperative function, and as much as a 2.5-fold reduction in wound complications. The site is secure. However, the risk of anterior knee pain following intramedullary nail . Data collection and analysis: This chapter describes the evolution of the nails that are used to treat fractures in upper limb bones and systematically describes the pros and cons of each device. Bilateral stress fractures of the anterior part of the tibial cortex. government site. Pre-operative radiographs with anterior cortical. Hua H, Zhang L, Guo Z, Zhong W, Chen J, Wang S, Guo J, Wang X. BMC Musculoskelet Disord. Am J Sports Med. Clipboard, Search History, and several other advanced features are temporarily unavailable. Forced hammering may cause fracture comminution, nail incarceration, or twisting of the nail. Clin Orthop Relat Res. If resistance is encountered, it may be caused by the wrong entry point, or the tip of the nail hitting the cortex of the distal fragment. Online ahead of print. Cochrane Database Syst Rev. 2022 May;18(2):284-289. doi: 10.1177/15563316211008176. eCollection 2019. Zbeda RM, Sculco PK, Urch EY, Lazaro LE, Borens O, Williams RJ, Lorich DG, Wellman DS, Helfet DL. Chronic tibial stress fracture is an unusual condition that is primarily seen in athletes and military personnel. eCollection 2018 Aug. Controlled laboratory study. Position. 2014 Sep 12;(9):CD004961. eCollection 2018 Aug. Komatsu J, Mogami A, Iwase H, Obayashi O, Kaneko K. Arch Orthop Trauma Surg. Shaner AC, Spiker AM, Goolsby MA, Kelly BT, Helfet DL. Tension band plating of an anterior tibial stress fracture nonunion in an elite athlete, initially treated with intramedullary nailing: a case report. -, Plasschaert VF, Johansson CG, Micheli LJ. Two-year post-operative radiographs with tibial. Front Pediatr. Knee Surg Sports Traumatol Arthrosc. Garabano G, Pereira S, Perez Alamino L, Ernst G, Pesciallo CA, Bidolegui F. Eur J Orthop Surg Traumatol. 2022 Mar 5;23(1):209. doi: 10.1186/s12891-022-05161-8. Would you like email updates of new search results? Cruz AS, de Hollanda JP, Duarte A Jr, Hungria Neto JS. 2018 Feb;28(2):299-304. doi: 10.1007/s00590-017-2041-6. Chronic anterior midtibial stress fractures in athletes treated with reamed intramedullary nailing. J Hip Preserv Surg. Objectives: To assess the effects (benefits and harms) of different methods and types of intramedullary nailing for treating tibial shaft fractures in adults. Intramedullary fixation is valuable and appropriate for the majority of tibial fractures. Intramedullary nails for extracapsular hip fractures in adults. Bethesda, MD 20894, Web Policies radiolucent OR table. We believe intramedullary tibial nailing should be considered for treating chronic stress fractures of the midanterior tibia that are recalcitrant to nonoperative therapy in a selected group of patients. The mean FOD values for all plates were 28% to 46% less than those for the saw cut alone. Abstract. Griffin XL, Parsons N, Zbaeda MM, McArthur J. Cochrane Database Syst Rev. The fracture went on to complete healing. MeSH biomechanics; intramedullary nail; locking compression plate; stress fracture. Post-operative radiographs with tibial nail,. In each case there were several similarities in symptoms and, most notably, radiographic findings and failure of nonoperative therapy for more than 1 year. Tension band plating of an anterior tibial stress fracture nonunion in an elite athlete, initially treated with intramedullary nailing: a case report. Study design: Shaner AC, Spiker AM, Goolsby MA, Kelly BT, Helfet DL. Recurrent or recalcitrant stress fractures can be ca reer-ending because they require lengthy nonoperative treatment. J Am Acad Orthop Surg. -, Chang PS, Harris RM. Epub 2013 Jan 19. Both intramedullary nails were removed and a tension plate was applied with an autologous iliac crest graft on the right tibia. Boden BP, Osbahr DC. Intramedullary nailing for tibial shaft fractures in adults. Although intramedullary nailing can achieve satisfactory tibiotalocalcaneal arthrodesis, the stress risers in the tibial diaphyses do result in a stress reaction in a significant number . When non-operative treatment fails, the optimal surgical treatment is controversial. For the 75% saw cut depth, the mean FOD values for all IM nail constructs were 13% to 17% less than those for the saw cut alone; the use of locking screws had no significant effect on the FOD. Chronic anterior midtibial stress fractures in athletes treated with reamed intramedullary nailing. Intramedullary nailing is the treatment of choice for fractures of the tibial shaft, which might necessitate the nail removal due to complications in the long-term. After sustaining a complete fracture at the site of the stress fracture, he was treated with intramedullary rodding and was able to dance 21 weeks after surgery. 8 Pain in the knee is a frequent complication in 22% to 71% of the . Would you like email updates of new search results? Please enable it to take advantage of the complete set of features! Background: Leg pain in athletes is a common condition and is often related to tibial stress fracture. When conservative management for mid-diaphyseal anterior stress fractures fails, the utilization of prophylactic tibial nailing is a viable option. doi: 10.1002/14651858.CD008241.pub2. -, Snyder RA, Koester MC, Dunn WR. Effectiveness of Nail Dynamization in Delayed Union of Tibial Shaft Fractures: Relationship Between Fracture Morphology, Callus Diameter, and Union Rates. Anterior stress fractures of the tibial shaft are tension-sided high-risk stress fractures with significant risks of delayed union, nonunion, and fracture propagation. Recurrent or recalcitrant stress fractures can be ca reer-ending because they require lengthy nonoperative treatment. Anterior stress fractures of the tibial shaft are tension-sided high-risk stress fractures with significant risks of delayed union, nonunion, and fracture propagation. 2005 Jul;33(7):1071-6. doi: 10.1177/0363546504271968. Tension Band Plating for Chronic Anterior Tibial Stress Fractures in High-Performance Athletes. Clipboard, Search History, and several other advanced features are temporarily unavailable. Internal fixation is appropriate in a small minority of cases when other treatments have failed. The nail should advance into the medullary canal with each tap of the hammer. Careers. Clipboard, Search History, and several other advanced features are temporarily unavailable. Intramedullary stabilization of the tibia is indicated in patients with multiple injuries; an ipsilateral fracture of the femur, ankle, or foot; a vascular injury; compartment syndrome; and bilateral fractures. Internal fixation is appropriate in a small minority of cases w The site is secure. Careers. Nine randomised and two quasi-randomised clinical trials, involving a total of 2093 participants with 2123 fractures, were included. A meta-analysis of reamed versus unreamed intramedullary nailing for the treatment of closed tibial fractures. The site is secure. Even after guide-wire insertion, further correction of alignment may be needed to avoid deformity. Madhuri V, Dutt V, Gahukamble AD, Tharyan P. Evid Based Child Health. 1 The use of intramedullary nails for distal tibia fractures has been associated with a 12%-23% incidence of malunion, 1 but use of the suprapatellar insertion technique reduces this rate to 3.8% . 8600 Rockville Pike Clin J Sports Med. The evidence was dominated by one large multicentre trial of 1319 participants. 'Low' quality evidence suggests that the Ender nail has poorer results in terms of re-operation and malunion than an interlocking nail. This site needs JavaScript to work properly. An anterior skin incision over the patellar tendon is used. When nonoperative treatment has failed, intramedullary (IM) nail and plate fixation are 2 surgical options used to arrest the progression of a fatigue fracture and allow bone healing. Federal government websites often end in .gov or .mil. A tibial shaft stress fracture is an overuse injury where normal or abnormal bone is subjected to repetitive stress, resulting in microfractures. Knee Surg Sports Traumatol Arthrosc. High-risk stress fractures:Evaluation and treatment. 2015 Aug 13;2015(8):CD010606. Background: A review of five cases. 2014 Jul 29;2014(7):CD009076. This site needs JavaScript to work properly. The percentage FOD reductions for all plate constructs and the unlocked IM nail were significantly less with a 50% saw cut depth. An official website of the United States government. Chung JS, Sabatino MJ, Fletcher AL, Ellis HB. The differences between the two nails in the incidence of deep infection or neurological defects were not statistically significant.The trial comparing one distal screw versus two distal screws found no statistically significant difference in nonunion between the two groups. He presented . Intramedullary nailing for tibial shaft fractures in adults. The .gov means its official. Epidemiology. Tension band plating of an anterior tibial stress fracture nonunion in an elite athlete, initially treated with intramedullary nailing: a case report. Use of a Minimally Invasive Traction Repositor versus Conventional Manual Traction for the Treatment of Tibial Fractures: A Comparative Study from a Tertiary Hospital in China. Recurrent or recalcitrant stress fractures can be ca reer-ending because they requi. Bethesda, MD 20894, Web Policies Anterior tibial stress fracture treated with intramedullary nailing:A case report. 2014 Apr;37(4):e332-8. and transmitted securely. Duan X, Al-Qwbani M, Zeng Y, Zhang W, Xiang Z. Cochrane Database Syst Rev. intramedullary nailing may be extended proximally or distally, but they. Epidemiology of stress fractures. Careers. Unable to load your collection due to an error, Unable to load your delegates due to an error. Interventions for treating fractures of the distal femur in adults. Unable to load your collection due to an error, Unable to load your delegates due to an error. Queally JM, Harris E, Handoll HH, Parker MJ. Front Pediatr. PMC Accessibility Metaphyseal-diaphyseal junctional fractures at the proximal or distal ends are more problematic to treat secondary . 2012 Jan 18;1:CD008241. 2018 Aug 8;5(3):312-318. doi: 10.1093/jhps/hny019. Concurrent Bilateral Anterior Tibial Stress Fractures and Vitamin D Deficiency in an Adolescent Female Athlete: Treatment With Early Surgical Intervention. Duan X, Al-Qwbani M, Zeng Y, Zhang W, Xiang Z. Cochrane Database Syst Rev. Pre-operative radiographs with anterior cortical thickening and multiple linear cortical defects. Anterior midtibial stress fractures are an important clinical problem for patients engaged in high-intensity military activities or athletic training activities. The gold standard surgical treatment has traditionally been antegrade tibial intramedullary nailing. In our patient, a year of conservative treatment and later tibial drilling was unsuccessful. The site is secure. Search methods: Bookshelf A case report. patient supine with feet at the end of the bed, small bump under ipsilateral thigh. The purpose of this article is to report different outcomes of the same primary . However, it found significantly more implant failures in the one distal screw group (13/22 versus 1/20; RR 11.82, 95% CI 1.70 to 82.38).One trial found no statistically significant differences in functional outcomes or anterior knee pain at three year follow-up between the transtendinous approach and the paratendinous approach for nail insertion. FOIA At least two review authors independently performed study selection, risk of bias assessment, and data collection and extraction. Interviews were used to survey the patient's history and outcome. We present an 18-year-old collegiate bound athlete who sustained a tibial stress fracture with multiple cortical defects. Tibial; intramedullary nail; sports medicine; stress fractures; trauma. 2015 Feb;29(2):98-104. doi: 10.1097/BOT.0000000000000195. government site. 2007 Mar;21(3):172-7. doi: 10.1097/BOT.0b013e3180332dd2. sharing sensitive information, make sure youre on a federal This site needs JavaScript to work properly. FOIA official website and that any information you provide is encrypted Background: 1996; Borden, Osbahr, and Jmenez 2001).Stress fractures comprise as many as 10% of all sport injuries, with the tibia accounting for approximately 50% of diagnoses in athletes (Bennell et al. Chronic tibial stress fracture is an unusual condition that is primarily seen in athletes and military personnel. Zbeda RM, Sculco PK, Urch EY, Lazaro LE, Borens O, Williams RJ, Lorich DG, Wellman DS, Helfet DL. doi: 10.1002/14651858.CD009076.pub2. Epub 2017 Sep 18. Epub 2005 May 11. Antibiotic artificial bone implantation and external fixation for the treatment of infection after intramedullary nail fixation: a retrospective study of 33 cases. The mean FOD values for all plate constructs were significantly less than those for all IM nail constructs. doi: 10.5435/00124635-200600001-00030. Intramedullary nailing for chronic tibial stress fractures. 2012 Jan 18;1:CD008241. and transmitted securely. Pesciallo CA, Garabano G, Alamino LP, Dainotto TL, Gaggiotti S, Del Sel H. Indian J Orthop. Multiple conditions can cause chronic leg pain in the athlete. If Socioeconomic Stress Is a Relevant Factor in Fracture-Healing Outcomes, Should It Also Merit Intervention? Cochrane Database Syst Rev. This site needs JavaScript to work properly. Am J Sports Med. 1996;24:68892. doi: 10.1097/BOT.0000000000000698. Would you like email updates of new search results? with open physes, patients with very small medullary canals, or a. history of tibial osteomyelitis. Recurrent or recalcitrant stress fractures can be career-ending because they require lengthy nonoperative treatment. Kharazmi M, Michalsson K, Hallberg P, Schilcher J. Eur J Orthop Surg Traumatol. We reviewed each case regarding preoperative symptoms, preoperative treatment, surgery performed, radiographic findings, and functional outcome. tibia intramedullary nailing system. Federal government websites often end in .gov or .mil. Please enable it to take advantage of the complete set of features! We performed a retrospective review of five patients who underwent intramedullary tibial nailing for recalcitrant stress fractures at Womack Army Medical Center, Ft. Bragg, North Carolina, from 1991 to 1994. 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