Gutenberg Open Science: Retrograde tibial nailing : a minimally invasive and biomechanically superior alternative to angle-stable plate osteosynthesis in distal tibia fractures

Please use this identifier to cite or link to this item: http://doi.org/10.25358/openscience-7835

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DC Field	Value	Language
dc.contributor.author	Kuhn, Sebastian	-
dc.contributor.author	Appelmann, Philipp	-
dc.contributor.author	Mehler, Dorothea	-
dc.contributor.author	Pairon, Philip	-
dc.contributor.author	Rommens, Pol Maria	-
dc.date.accessioned	2022-10-05T08:25:56Z	-
dc.date.available	2022-10-05T08:25:56Z	-
dc.date.issued	2014
dc.identifier.uri	https://openscience.ub.uni-mainz.de/handle/20.500.12030/7850	-
dc.description.abstract	BACKGROUND: Currently, antegrade intramedullary nailing and minimally invasive plate osteosynthesis (MIPO) represent the main surgical alternatives in distal tibial fractures. However, neither choice is optimal for all bony and soft tissue injuries. The Retrograde Tibial Nail (RTN) is a small-caliber prototype implant, which is introduced through a 2-cm-long incision at the tip of the medial malleolus with stab incisions sufficient for interlocking. During this project, we investigated the feasibility of retrograde tibial nailing in a cadaver model and conducted biomechanical testing. METHODS: Anatomical implantations of the RTN were carried out in AO/OTA 43 A1-3 fracture types in three cadaveric lower limbs. Biomechanical testing was conducted in an AO/OTA 43 A3 fracture model for extra-axial compression, torsion, and destructive extra-axial compression. Sixteen composite tibiae were used to compare the RTN against an angle-stable plate osteosynthesis (Medial Distal Tibial Plate, Synthes(R)). Statistical analysis was performed by Student's t test. RESULTS: Retrograde intramedullary nailing is feasible in simple fracture types by closed manual reduction and percutaneous reduction forceps, while in highly comminuted fractures, the use of a large distractor can aid the reduction. Biomechanical testing shows a statistically superior stability (p < 0.001) of the RTN during non-destructive axial loading and torsion. Destructive extra-axial compression testing resulted in failure of all plate constructs, while all RTN specimens survived the maximal load of 1,200 N. CONCLUSIONS: The prototype retrograde tibial nail meets the requirements of maximum soft tissue protection by a minimally invasive surgical approach with the ability of secure fracture fixation by multiple locking options. Retrograde tibial nailing with the RTN is a promising concept in the treatment of distal tibia fractures.	en_GB
dc.description.sponsorship	DFG, Open Access-Publizieren Universität Mainz / Universitätsmedizin	de
dc.language.iso	eng	de
dc.rights	CC BY	*
dc.rights.uri	https://creativecommons.org/licenses/by/4.0/	*
dc.subject.ddc	610 Medizin	de_DE
dc.subject.ddc	610 Medical sciences	en_GB
dc.title	Retrograde tibial nailing : a minimally invasive and biomechanically superior alternative to angle-stable plate osteosynthesis in distal tibia fractures	en_GB
dc.type	Zeitschriftenaufsatz	de
dc.identifier.doi	http://doi.org/10.25358/openscience-7835	-
jgu.type.dinitype	article	en_GB
jgu.type.version	Published version	de
jgu.type.resource	Text	de
jgu.organisation.department	FB 04 Medizin	de
jgu.organisation.number	2700	-
jgu.organisation.name	Johannes Gutenberg-Universität Mainz	-
jgu.rights.accessrights	openAccess	-
jgu.journal.title	Journal of orthopaedic surgery and research	de
jgu.journal.volume	9	de
jgu.pages.alternative	Art. 35	de
jgu.publisher.year	2014	-
jgu.publisher.name	BioMed central	de
jgu.publisher.place	London	de
jgu.publisher.uri	http://dx.doi.org/10.1186/1749-799X-9-35	de
jgu.publisher.issn	1749-799X	de
jgu.organisation.place	Mainz	-
jgu.identifier.pmid	24886667
jgu.subject.ddccode	610	de
opus.date.modified	2018-08-08T08:57:20Z
opus.subject.dfgcode	00-000
opus.organisation.string	FB 04: Medizin: Klinik und Poliklinik für Unfallchirurgie	de_DE
opus.identifier.opusid	27365
opus.importsource	pubmed
opus.institute.number	0439
opus.metadataonly	false
opus.type.contenttype	Keine	de_DE
opus.type.contenttype	None	en_EN
opus.affiliated	Kuhn, Sebastian
opus.affiliated	Rommens, Pol Maria
jgu.publisher.doi	10.1186/1749-799X-9-35	de
jgu.organisation.ror	https://ror.org/023b0x485	-
Appears in collections:	DFG-OA-Publizieren (2012 - 2017)

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