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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 2, 227-231.
doi: 10.1302/0301-620X.88B2.16456  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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Factors affecting fracture healing after intramedullary nailing of the tibial diaphysis for closed and grade I open fractures

G. I. Drosos, MD, PhD, Consultant Orthopaedic Surgeon1; M. Bishay, FRCS, Consultant Orthopaedic Surgeon2; I. A. Karnezis, MD, MSc, FRCS(Tr&Orth), Consultant Orthopaedic Surgeon3; and A. K. Alegakis, PhD, Research Fellow4

1 Athens Naval Hospital, Ag. Sofias 29, 154 51 Neo Psichiko, Athens, Greece.
2 Orthopaedic Department Royal United Hospital, Bath BA1 3NG, Somerset, UK.
3 Athens Medical Centre, Andersen 1, 11525 Athens, Greece.
4 Biostatistics Laboratory, Department of Social Medicine University of Crete, 71409 Heraklion, Crete, Greece.

Correspondence should be sent to Dr G. I. Drosos; e-mail: drosos{at}otenet.gr

As there is little information on the factors that influence fracture union following intramedullary nailing of the tibia we retrospectively investigated patient-, injury- and treatment-related factors in 161 patients with closed or grade I open fractures of the tibial diaphysis. The patients were reviewed until clinical and radiological evidence of union at a mean of 13.3 months (4 to 60). Multivariate statistical analysis using a Cox proportional hazards model showed that the risk of failure of union increased by 2.38 times for highly comminuted fractures, by 3.14 times when nail dynamisation was applied, and by 1.65 times when the locking screws failed. In fractures with no or only minimal comminution the risk of nonunion increased if the post-reduction gap was ≥ 3 mm.




eLetters:

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Nail diameter and dynamisation
Dr. Anil Agarwal
J Bone Joint Surg Br Online, 13 Feb 2006 [Full text]
Factors affecting healing of tibial shaft fractures
Antti S Kyrö, et al.
J Bone Joint Surg Br Online, 15 May 2006 [Full text]

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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General