Effect of using a trephine to extract bone at the insertion point of the intramedullary nails and graft bone at the fractured ends in the treatment of tibial shaft fractures with intramedullary nail
Year: 2025
Type: article
Abstract: Objective: To explore the effect of using a trephine to extract bone at the insertion point of the intramedullary nails (IMN) and graft bone at the fractured ends in the treatment of tibial shaft fractures with IMN. Methods: In this single-center retrospective study, patients who underwent treatment for tibial shaft fracture using IMN between January 2016 and December 2019 at Fudan University Jinshan Hospital were retrospectively analyzed. There were two groups. In the study group, a trephine was used to extract bone chips at the insertion point of the IMN, which were grafted at the fractured ends. The control group comprised sex- and age-matched patients with similar fracture location and classification, but without bone graft at the fractured ends. The surgery time, fracture healing time, and frequency of IMN dynamic surgery were compared between the two groups. Furthermore, the Johner-Wruhs score, WHO-QOL score, and knee joint range of motion at six and 12 months after surgery were compared. Results: Both groups had 99 matched patients (69 male and 30 female). The median healing time was significantly shorter in the study group (z=-2.86, p=0.004). Five cases (5.05%) in the study group and 10 cases (10.10%) in the control group underwent IMN dynamic surgery; the between-group difference in this respect was not statistically significant (c2=1.803, p=0.179). There was no significant between-group difference regarding the other parameters. Conclusions: The surgical technique can promote healing of tibial shaft fractures with no adverse effect on postoperative functional recovery. doi: https://doi.org/10.12669/pjms.41.4.10259 How to cite this: Xu Z, Cai G, He X, Li D. Effect of using a trephine to extract bone at the insertion point of the intramedullary nails and graft bone at the fractured ends in the treatment of tibial shaft fractures with intramedullary nail. Pak J Med Sci. 2025;41(4):1176-1180. doi: https://doi.org/10.12669/pjms.41.4.10259 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Authors: Zhaoning Xu, Guoping Cai, Xianwei He, Defang Li
Institutions: Fudan University, Jinshan Hospital of Fudan University
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $400
OpenAlex ID: W4408966340