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- W2908348529 abstract "Objectives: To assess the relationship between the distal nail target and postoperative alignment for distal tibia fractures treated with intramedullary nailing. Design: Retrospective cohort study. Setting: A single level 1 trauma center. Patients/Participants: One hundred thirty distal tibia fractures treated with intramedullary nailing over a 10-year period. Main Outcome Measurements: Malalignment >5 degrees. Results: Thirty-eight cases (29.2%) of malalignment >5 degrees included valgus (19 cases, 14.6%), procurvatum (13 cases, 10.0%), recurvatum (1 case, 0.8%), and combined valgus with procurvatum (5 cases, 3.8%). Medially directed nails demonstrated relative valgus (mean lateral distal tibia angle 86.4 vs. 89.4 degrees, P < 0.01) and more frequent coronal malalignment (24 of 78, 30.8% vs. 0 of 52, 0%, P < 0.01). Anteriorly directed nails demonstrated relative procurvatum (mean anterior distal tibia angle 82.8 vs. 80.9 degrees, P < 0.01) and more frequent sagittal malalignment (15 of 78, 19.2% vs. 3 of 52, 5.8%, P = 0.03). Malalignment was less common for nails targeting the central or slightly posterolateral plafond (0 of 30, 0% vs. 38 of 100, 38%), P < 0.01. Multivariate analysis demonstrated the distal nail target ( P = 0.03), fracture within 5 cm of the plafond ( P = 0.01), as well as night and weekend surgery ( P = 0.03) were all independently associated with malalignment. Conclusions: Alignment of distal tibia fractures is sensitive to both injury and treatment factors. Nails should be targeted centrally or slightly posterolaterally to minimize malalignment. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence." @default.
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- W2908348529 date "2019-03-01" @default.
- W2908348529 modified "2023-10-18" @default.
- W2908348529 title "Distal Nail Target and Alignment of Distal Tibia Fractures" @default.
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- W2908348529 doi "https://doi.org/10.1097/bot.0000000000001358" @default.
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