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Intramedullary nail diameter to canal diameter ratio determined healing of tibial shaft fractures
To optimize healing after intramedullary nailing of extra-articular tibial shaft fractures, recently published results suggest the intramedullary nail diameter to canal diameter ratio should be between 0.8 and 0.99.
For at least 12 months, researchers followed serial radiographs of 78 patients with tibial shaft fractures that underwent intramedullary nailing as definitive fixation between June 2004 and July 2012 to determine time to healing as a function of nail to canal ratio. Researchers assessed healing at 3 months, 6 months, 9 months and 12 months using Radiographic Union Scale for Tibial fractures criteria.
Samir Mehta
Results showed 67% of patients had evidence of radiographic healing by 12 months, with intramedullary nail to canal ratios between 0.8 to 0.99 identified in instances of early time to union. Researchers found patients were 4.4-times more likely to not heal by 12 months if they had an intramedullary nail to canal ratio of less than 0.8 or greater than 0.99. Due to a larger percentage of optimal nail to canal ratios between 0.8 and 0.99, patients with proximal or midshaft fractures were more likely to proceed to union vs. patients with distal third fractures, according to results. – by Casey Tingle
Disclosure: The researchers report no relevant financial disclosures.