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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
TRAUMA AND EMERGENCY SURGERY
Minerva Ortopedica e Traumatologica 2012 February;63(1):45-59
Intramedullary nailing of distal tibial fractures
Kuhn S., Dietz S.-O., Appelmann P., Rothenbach E. C., Rommens P. M.
Department of Trauma Surgery, University Hospital of the Johannes Gutenberg, University of Mainz, Mainz, Germany
Intramedullary nailing is an alternative to plate osteosynthesis for the treatment of distal metaphyseal tibial fractures. Intramedullary nailing offers stable fixation while preserving the vascularity of the fracture site and the integrity of the surrounding soft-tissue. In the past, concerns have been raised regarding the stability of fixation and the risk of malunion. Modern tibial nails incorporate several technical modifications compared to standard implants. The numerous multiplanar locking options in close proximity to the nail end, allow for secure stabilization of distal metaphyseal fractures. Certain articular tibial fractures can be addressed by intramedullary nailing alone or in combination with other implants. Clinical case series show favorable results that support the broadening indications for intramedullary nailing in distal tibial fractures.