Acta Chir Orthop Traumatol Cech. 2015; 82(3):203-208 | DOI: 10.55095/achot2015/030

Retrograde Tibial Nail: Anatomical Implantation and Surgical Feasibility StudyOriginal papers

S. KUHN*, P. APPELMANN, P. PAIRON, D. GRUSZKA, P. M. ROMMENS
Department of Orthopaedics and Traumatology, University Medical Centre of the Johannes Gutenberg University, Mainz, Germany

PURPOSE OF THE STUDY:
The treatment of distal tibial fractures requires a stable fixation while minimizing the secondary trauma to the soft tissues by the surgical approach and implant. The experimental Retrograde Tibial Nail is currently investigated as a minimally invasive alternative to plating and antegrade nailing. The purpose of this study was to evaluate the surgical feasibility in a cadaver model for all distal tibial fracture types generally considered treatable by nailing.

MATERIAL AND METHODS:
Five different fracture types (AO/OTA 43-A1/A2/A3 and 43-C1/C2) were created on separate cadaveric limbs. In simple fractures (AO/OTA 43-A1/A2/A3) primary nailing was performed. In intraarticular fractures (AO/OTA 43-C1/2) reduction of the articular block and lag screw fixation was performed before nailing. Intraoperative complications, quality of reduction, fluoroscopy duration and operative time were evaluated.

RESULTS:
Retrograde intramedullary nailing is feasible in simple fracture types by closed manual reduction and percutaneous reduction forceps. Retrograde nailing is possible in fractures with simple intraarticular involvement after primary lag screw fixation. The duration of surgery averaged 51.8 minutes (range 40-62 min). No major complications occurred during nailing.

CONCLUSIONS:
The minimally invasive retrograde nail combines a minimally invasive local osteosynthesis with the ability to adequately fix extraarticular and simple intraarticular distal tibial fractures. The results suggests that retrograde tibia nailing is a promising new concept for the treatment of distal tibia fractures.

Keywords: minimally invasive surgery, tibia, metaphyseal fractures, intramedullary nailing, retrograde nailing

Published: June 1, 2015  Show citation

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KUHN S, APPELMANN P, PAIRON P, GRUSZKA D, ROMMENS PM. Retrograde Tibial Nail: Anatomical Implantation and Surgical Feasibility Study. Acta Chir Orthop Traumatol Cech. 2015;82(3):203-208. doi: 10.55095/achot2015/030. PubMed PMID: 26317291.
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