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Retrograde tibial nailing : a minimally invasive and biomechanically superior alternative to angle-stable plate osteosynthesis in distal tibia fractures

Journal of orthopaedic surgery and research. Bd. 9. London: BioMed central 2014 Art. 35

Erscheinungsjahr: 2014

ISBN/ISSN: 1749-799X

Publikationstyp: Zeitschriftenaufsatz

Sprache: Englisch

Doi/URN: 10.1186/1749-799X-9-35

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Inhaltszusammenfassung


BACKGROUND: Currently, antegrade intramedullary nailing and minimally invasive plate osteosynthesis (MIPO) represent the main surgical alternatives in distal tibial fractures. However, neither choice is optimal for all bony and soft tissue injuries. The Retrograde Tibial Nail (RTN) is a small-caliber prototype implant, which is introduced through a 2-cm-long incision at the tip of the medial malleolus with stab incisions sufficient for interlocking. During this project, we investigated the fe...BACKGROUND: Currently, antegrade intramedullary nailing and minimally invasive plate osteosynthesis (MIPO) represent the main surgical alternatives in distal tibial fractures. However, neither choice is optimal for all bony and soft tissue injuries. The Retrograde Tibial Nail (RTN) is a small-caliber prototype implant, which is introduced through a 2-cm-long incision at the tip of the medial malleolus with stab incisions sufficient for interlocking. During this project, we investigated the feasibility of retrograde tibial nailing in a cadaver model and conducted biomechanical testing. METHODS: Anatomical implantations of the RTN were carried out in AO/OTA 43 A1-3 fracture types in three cadaveric lower limbs. Biomechanical testing was conducted in an AO/OTA 43 A3 fracture model for extra-axial compression, torsion, and destructive extra-axial compression. Sixteen composite tibiae were used to compare the RTN against an angle-stable plate osteosynthesis (Medial Distal Tibial Plate, Synthes(R)). Statistical analysis was performed by Student's t test. RESULTS: Retrograde intramedullary nailing is feasible in simple fracture types by closed manual reduction and percutaneous reduction forceps, while in highly comminuted fractures, the use of a large distractor can aid the reduction. Biomechanical testing shows a statistically superior stability (p » weiterlesen» einklappen

Autoren


Kuhn, Sebastian (Autor)
Appelmann, Philipp (Autor)
Mehler, Dorothea (Autor)
Pairon, Philip (Autor)
Rommens, Pol Maria (Autor)

Klassifikation


DDC Sachgruppe:
Medizin