Journal of Musculoskeletal Trauma

Original Articles

Anatomical Assessment of the Proper Insertion Site for a Tibial Nailing: Soo Yong Kang, Eun Woo Lee, Ki Ser Kang, Han Jun Lee, Ho Joong Jung, Pyeong Ho Jeong; J Korean Fract Soc 2004;17(2):142-147. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.142

PURPOSE
To investigate the proper insertion site for a tibial intramedullary nail in the Korean.
MATERIALS AND METHODS
Forty volunteers without trauma below knee joint were studied to determine relationship between central axis of medullary canal and lateral tibial spine, patellar tendon and the proper insertion site, and to evaluation changes of proper insertion site during rotation of knee and effective diameter.
RESULTS
The proper insertion site located average 4.3+/-0.9 mm medial to the lateral tibial spine. The proper insertion site was in the medial 1/3 of patellar tendon in 6 knees, middle 1/3 of patellar tendon in 20 knees, and lateral 1/3 of patellar tendon in 14 knees. The proper insertion site might be changed two times in internal rotation more than in external rotation. The effective diameter was more narrow in medial slope than in lateral slope at proximal tibia.
CONCLUSION
The study indicates the ideal insertion site of tibial nail is the medial aspect of the lateral tibial spine in Korean. To reduce the mal-reduction from a improper insertion site, lateral insertion site might be safer than medial one. However, individual variations in the relationship between the patellar tendon and tibial medullary canal should be considered.

Citations

Citations to this article as recorded by

Three-dimensional analysis of the intramedullary canal axis of tibia: clinical relevance to tibia intramedullary nailing
Sang Jun Song, B. O. Jeong
Archives of Orthopaedic and Trauma Surgery.2010; 130(7): 903. CrossRef
Three Dimensional Analysis for the Intramedullary Canal Axis of the Proximal Tibia: Clinical Relevance to Total Knee Arthroplasty
Sang Jun Song, Choong Hyeok Choi
The Journal of the Korean Orthopaedic Association.2007; 42(3): 345. CrossRef

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Unreamed interlocking nailing in tibia fracture: You Sung Suh, Young Il Cho, Ho Won Jung, Yeon Il Kim; J Korean Soc Fract 2002;15(4):470-476. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.470

Abstract PDF: PURPOSE
To evaluate of clinical results and malunion according to nail insertion site and early ambulation after unreamed interlocking intramedullary nailing for the treatment of tibial fractures, MATERIALS AND METHODS: We reviewed 46 tibial fractures that were treated with unreamed static intramedullary nailing prospectively from March 1997 to May 2001. Nail insertion site and angulation of fracture site were reviewed by radiograph. All of 46 cases, ambulation was started at postoperative 2 weeks, and then clinical outcomes were reveiwed RESULTS: In all 46 cases, union was achieved at average 18.2 weeks clinically and average 19.4 weeks radiographically. There is no significant difference in angulation according to nail insertion site, i,.e. after central/medial/lateral insertion, outcome was 2 . 4 5 degrees +/-2 . 1 7 / 2 . 2 2 degrees +/-1 . 8 4 / 1 . 7 3 degrees +/-1.33(p; 0.705) in last follow up anterioposterior view, and 1.81 degrees +/-1 . 1 3 / 2 . 6 7 degrees +/-1 . 6 2 / 2 . 0 0 degrees +/-1.64(p; 0.320) in last follow up lateral view. No breakage of intramedullary nails and no stiffness on adjacent joints.
CONCLUSION
We confirmed that unreamed interlocking nailing in tibial fractures is one of the effective method for low recurrence of malunion and early ambulation

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