This journal is
indexed in Scopus
Year 2018 Vol. 26 No 2
TRAUMATOLOGY & ORTHOPEDICS
YE.N. TOKTAROV, M.A. ZHANASPAYEV, A.S. TLEMISSOV, D.T. BAKHTYBAEV, A.O. MYSSAYEV
INTERLOCKING NAILING OF TIBIA SHAFT FRACTURES BY EXPANDABLE NAIL: NON-RANDOMIZED CONTROLLED TRIAL
Semey State Medical University, Semey
The Republic of Kazakhstan
Objective. To improve the treatment results of the tibia diaphysis fracture by the designed device for intraosseous interlocking osteosynthesis.
Methods. It was a non-randomized controlled trial. There were two groups of patients (n=163): the main group (n=41) who underwent the fracture treatment by the designed device; the control group (n=122) who were treated with the ChM interlocking nail. The groups were comparable in age (p=0.066), sex (p=0.824), fracture level (p=0.659), type of injury (p=0.189) and fracture type (p=0.566). Preoperative and postoperative patients’ management was identical.
Results. The period of disability to work in the main group (M=62.8; Me=63.0; IQR=11 days) was shorter than in the control group (M=87.4; Me=82.0; IQR=28 days) (p<0.001). Also, higher weight bearing ability at the time of discharge (M=45.7 vs. M=33.0); and 1 month after the operation (M=90.9 vs. M=86.5) and earlier time for restoration of ability to walk without crutches (M=29.3 vs. 64.9 days) were registered in the main group vs. the control (p<0.001; p=0.018; p<0.001 respectively). At the same time, the number of inpatient days in the groups did not differ statistically (17.4 days in the control vs. 18.1 days in the main). There was not statistically significant difference in weight bearing ability at terms of 3 months after surgery (in both groups it reached 100%, p=0.059); number of complications (p=0.369); presence of shortening (p=0.149); treatment outcomes (p=0.849).
Conclusions. In this study, the designed expandable nail for interlocking osteosynthesis of the tibia shaft fracture enabled faster recovery of the patients’ ability to work. At the same time, for such parameters as inhospital stay, the presence of shortening and complications, the outcome of the treatment, the designed nail was not worse than the standard ChM nail.
- Madadi F, Eajazi A, Madadi F, Daftari Besheli L, Sadeghian R, Nasri Lari M. Adult tibial shaft fractures – different patterns, various treatments and complications. Med Sci Monit. 2011 Nov;17(11):CR640-645. doi: 10.12659/MSM.882049.
- Madadi F, Vahid Farahmandi M, Eajazi A, Daftari Besheli L, Madadi F, Nasri Lari M. Epidemiology of adult tibial shaft fractures: a 7-year study in a major referral orthopedic center in Iran. Med Sci Monit. 2010 May;16(5):CR217-21.
- Larsen P, Elsoe R, Hansen SH, Graven-Nielsen T, Laessoe U, Rasmussen S. Incidence and epidemiology of tibial shaft fractures. Injury. 2015 Apr;46(4):746-50. doi: 10.1016/j.injury.2014.12.027.
- Ediev MS, Morozov VP. Kombinirovannyi osteosintez diafizarnykh perelomov kostei goleni kak metod optimizatsii biomekhanicheskikh uslovii. Sarat Nauch-Med Zhurn. 2005;1(3):45-52. (in Russ.)
- Poletti FL, Macmull S, Mushtaq N, Mobasheri R Current concepts and principles in open tibial fractures – Part II Management and controversies. MOJ Orthop Rheumatol. 2017;8(2):00305. doi: 10.15406/mojor.2017.08.00305.
- Pisarev VV, Aleinikov AV, Vasin IV, Oshurkov YuA. Analysis of the results of different types of diaphyseal tibial fractures with intraosseous and of plate osteosynthesis. Travmatologiia i Ortopediia Rossii. 2013;(3):29-36. (in Russ.)
- Zelle BA, Boni G. Safe surgical technique: intramedullary nail fixation of tibial shaft fractures. Patient Saf Surg. 2015;9:40. Published online 2015 Dec 12. doi: 10.1186/s13037-015-0086-1.
- Hee HT, Wong HP, Low YP, Myers L. Predictors of outcome of floating knee injuries in adults: 89 patients followed for 2-12 years. Acta Orthop Scand. 2001 Aug;72(4):385-94. doi: 10.1080/000164701753542050.
- Kajzer A, Kajzer W, Marciniak J. Expandable intramedullary nail – experimental biomechanical evaluation. Int Sci J. 2010 Jan;41(Is I):45-52.
- Kutsenko SN, Mitiunin DA, Nikiforov RR. Rol’ vnutrikostnogo osteosinteza v sisteme khirurgicheskogo lecheniia perelomov kostei goleni i ikh posledstvii: mezhdunarodnyi opyt i sobstvennye rezul’taty. L³topis Travmatolog³³ ta Ortoped³³. 2013;(1/2):157-68. (in Russ.) http://nbuv.gov.ua/UJRN/Lto_2013_1-2_42.
- Sakhvadze Sh. Biological osteosynthesis as the treatment mode for multifragmental extra-articular fractures. Georgian Med News. 2009 Mar;(168):15-20.
071400, The Republic of Kazakhstan,
East Kazakhstan region,
Semey, Abaya Str., 103,
Semey State Medical University,
Department of Public Health,
Tel/fax: +7 (7222) 56 97 55,
Myssayev Ayan O.
Toktarov Yernar N., PhD Student of the Department of Traumatology and Orthopedics, Semey State Medical University, Semey, Republic of Kazakhstan.
Zhanaspayev Marat A., Doctor of medical Science, Head of the Department of Traumatology and Orthopedics, Semey State Medical University, Semey, Republic of Kazakhstan.
Tlemissov Aidos S., PhD, Assistant of the Department of Traumatology and Orthopedics, Semey State Medical University, Semey, Republic of Kazakhstan.
Bakhtybaev Daryn T., Assistant of the Department of Traumatology and Orthopedics, Semey State Medical University, Semey, Republic of Kazakhstan.
Myssayev Ayan O., PhD, Associate Professor, Head of the Department of Public Health, Semey State Medical University, Semey, Republic of Kazakhstan.