Highlights
- •We used a tibial traction triangle to treat distal tibia fractures with infrapatellar intramedullary nailing to determine rate of malalignment greater than 5°.
- •Of the 81 patients in the study, primary malalignment occurred in 4.9%, all in the coronal plane, with mean coronal alignment of 1.72° valgus.
- •Use of this device leads to a very low rate of primary malalignment with infrapatellar nailing, even in extremely distal fractures.
Abstract
Objectives
To report on the immediate postoperative alignment of distal tibia fractures (within
10 cm of the tibial plafond) treated with infrapatellar intramedullary nailing (IMN)
using the tibial traction triangle (TTT).
Methods
We performed a retrospective cohort study at a Level-I academic trauma center, with
eighty-one skeletally mature patients with closed distal tibia fractures treated over
a 10-year period with closed infrapatellar intramedullary nailing, without fibula
fixation, using the TTT. The primary outcome measure is primary malalignment ≥5°.
Results
Primary malalignment occurred in 4 (4.9%) patients, all in the coronal plane. Mean
coronal plane alignment was 1.72° valgus (range 3° varus to 8° valgus). No sagittal
malalignment occurred. The fibula was intact in 5 (6.2%) cases. No patients underwent
fibula fixation or blocking screw placement. Intra-articular extension occurred in
28 (34.6%) cases. Mean fracture distance from the plafond was 5.98 cm. Thirty-one
patients had a fracture within 5 cm of the plafond, where malalignment was noted in
2 (6.5%) patients.
Conclusions
This is the first analysis of a large cohort of patients with distal tibia fractures
treated with the TTT. Use of this device leads to a very low rate of primary malalignment
with infrapatellar nailing, even in extremely distal fractures. We recommend consideration
of this device as one more adjunct to help treat these difficult fractures successfully.
Keywords
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References
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Article info
Publication history
Published online: February 08, 2022
Accepted:
February 5,
2022
Identification
Copyright
Published by Elsevier Ltd.
