Abstract
Intramedullary nailing is the accepted treatment of femoral and tibial shaft fractures.
Improvements in surgical techniques and implant designs have extended indications
for nailing to metaphyseal fractures of the proximal tibia, distal tibia and the distal
femur. Malalignment can still occur with intramedullary nailing of these fractures.
Among many techniques that have been described, the use of a ‘poller screw’ or ‘blocking
screw’ is one of the methods that may be used to aid in satisfactory fracture reduction
and biomechanical stability. To our knowledge, the use of a Steinman pin as the initial
step in poller screw insertion has not been reported in the English literature. We
report a new technique of poller screw using Steinman pin localisation with tibial
and femoral nailing of metaphyseal fractures.
Keywords
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References
- Radiographic analysis of tibial fracture malalignment following intramedullary nailing.Clin Orthop Rel Res. 1995; 315: 25-33
- The mechanical effect of blocking screws (“poller screws”) in stabilizing tibia fractures with short proximal or distal fragments after insertion of small-diameter intramedullary nails.J Orthop Trauma. 1999; 13: 550-553
- The use of “poller screw” as blocking screws in stabilizing tibial fractures treated with small diameter intramedullary nails.J Bone Joint Surg Br. 1999; 81B: 963-968
- Retrograde versus antegrade nailing of femoral shaft fractures.J Orthop Trauma. 2001; 15: 161-169
- The logic and clinical applications of blocking screws.J Bone Joint Surg Am. 2004; 86A: 17-25
Zelle BA, Bhandari M, Espiritu M, et al. On behalf of the Evidence-Based Orthopaedic Trauma Working Group. Treatment of distal tibia fractures without articular involvement: a systematic review of 1125 fractures. J Orthop Trauma 2006;20:76–9.
Article info
Publication history
Accepted:
April 14,
2010
Identification
Copyright
© 2010 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
