Plate nail constructs for complex proximal tibia fractures
Purpose: To report upon a series of patients who underwent a combined minimally invasive plate osteosynthesis and intramedullary nailing surgical approach for AO/OTA 41C2/3 +/− 42, 41B2/3 + 42 fracture types and highlight the surgical methodology for application. Patients: 15 patients were treated w...
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| Language: | English |
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Elsevier
2025-08-01
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| Series: | Trauma Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352644025000950 |
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| author | Daniel Marks Matthew Dulas Solomon Egbe James Dahm Anthony Christiano Jason Strelzow |
| author_facet | Daniel Marks Matthew Dulas Solomon Egbe James Dahm Anthony Christiano Jason Strelzow |
| author_sort | Daniel Marks |
| collection | DOAJ |
| description | Purpose: To report upon a series of patients who underwent a combined minimally invasive plate osteosynthesis and intramedullary nailing surgical approach for AO/OTA 41C2/3 +/− 42, 41B2/3 + 42 fracture types and highlight the surgical methodology for application. Patients: 15 patients were treated with combined plate and intramedullary nail constructs at an academic urban trauma center from 2018 to 2022. All patients had AO/OTA 41C2/3 +/− 42 or 41B2/3 + 42 fractures. Intervention: The study intervention included retrospective review of patient charts and radiographs. Main outcome measures: Outcome measures included coronal and sagittal alignment at latest follow-up, intra-operative subsidence of articular fragments, reoperation, and complications such as infection, compartment syndrome, screw migration, or component failure. Results: The average follow-up for patients included was 6.2 months. At final follow-up, 13 patients had available post-operative assessments for review. At latest follow-up, the average coronal alignment ranged from 3.1 degrees of varus to 2.3 degrees of valgus, average sagittal alignment from 2.6 degrees of recurvatum to 2.0 degrees of procurvatum. There was no evidence of intra-operative or post-operative radiographic subsidence of the plateau. No patients underwent reoperation. There was one case of superficial infection and one case of proximal screw loosening. Discussion: Plate and nail constructs are a practical option for complex intra-articular fractures of the proximal tibia with metaphyseal or diaphyseal extension (AO/OTA 41C2/3 +/− 42, 41B2/3 + 42). This series demonstrates acceptable radiographic alignment and good clinical results associated with these fracture patterns, with short-to-medium-term follow-up and an overall low complication rate. |
| format | Article |
| id | doaj-art-910b0b455dff4def84786ff8d61cb504 |
| institution | DOAJ |
| issn | 2352-6440 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Trauma Case Reports |
| spelling | doaj-art-910b0b455dff4def84786ff8d61cb5042025-08-20T02:55:20ZengElsevierTrauma Case Reports2352-64402025-08-015810121810.1016/j.tcr.2025.101218Plate nail constructs for complex proximal tibia fracturesDaniel Marks0Matthew Dulas1Solomon Egbe2James Dahm3Anthony Christiano4Jason Strelzow5Department of Orthopaedic Surgery and Rehabilitation Medicine, The University of Chicago Medical Center, Chicago, IL 60637, USAThe University of Chicago Pritzker School of Medicine, Chicago, IL 60637, USAThe University of Chicago Pritzker School of Medicine, Chicago, IL 60637, USAThe Indiana Hand to Shoulder Center, Indianapolis, IN 46260, USADepartment of Orthopaedic Surgery and Rehabilitation Medicine, The University of Chicago Medical Center, Chicago, IL 60637, USAWashington University of St. Louis, Department of Orthopaedic Surgery, St. Louis, MO 63110, USA; Corresponding author at: Department of Orthopaedic Surgery, Washington University in St. Louis, 660 S Euclid Avenue, MSC: 8233-004-5505, St. Louis, MO 63110, USA.Purpose: To report upon a series of patients who underwent a combined minimally invasive plate osteosynthesis and intramedullary nailing surgical approach for AO/OTA 41C2/3 +/− 42, 41B2/3 + 42 fracture types and highlight the surgical methodology for application. Patients: 15 patients were treated with combined plate and intramedullary nail constructs at an academic urban trauma center from 2018 to 2022. All patients had AO/OTA 41C2/3 +/− 42 or 41B2/3 + 42 fractures. Intervention: The study intervention included retrospective review of patient charts and radiographs. Main outcome measures: Outcome measures included coronal and sagittal alignment at latest follow-up, intra-operative subsidence of articular fragments, reoperation, and complications such as infection, compartment syndrome, screw migration, or component failure. Results: The average follow-up for patients included was 6.2 months. At final follow-up, 13 patients had available post-operative assessments for review. At latest follow-up, the average coronal alignment ranged from 3.1 degrees of varus to 2.3 degrees of valgus, average sagittal alignment from 2.6 degrees of recurvatum to 2.0 degrees of procurvatum. There was no evidence of intra-operative or post-operative radiographic subsidence of the plateau. No patients underwent reoperation. There was one case of superficial infection and one case of proximal screw loosening. Discussion: Plate and nail constructs are a practical option for complex intra-articular fractures of the proximal tibia with metaphyseal or diaphyseal extension (AO/OTA 41C2/3 +/− 42, 41B2/3 + 42). This series demonstrates acceptable radiographic alignment and good clinical results associated with these fracture patterns, with short-to-medium-term follow-up and an overall low complication rate.http://www.sciencedirect.com/science/article/pii/S2352644025000950Case seriesFractureProximal tibiaIntramedullary nailingPlating |
| spellingShingle | Daniel Marks Matthew Dulas Solomon Egbe James Dahm Anthony Christiano Jason Strelzow Plate nail constructs for complex proximal tibia fractures Trauma Case Reports Case series Fracture Proximal tibia Intramedullary nailing Plating |
| title | Plate nail constructs for complex proximal tibia fractures |
| title_full | Plate nail constructs for complex proximal tibia fractures |
| title_fullStr | Plate nail constructs for complex proximal tibia fractures |
| title_full_unstemmed | Plate nail constructs for complex proximal tibia fractures |
| title_short | Plate nail constructs for complex proximal tibia fractures |
| title_sort | plate nail constructs for complex proximal tibia fractures |
| topic | Case series Fracture Proximal tibia Intramedullary nailing Plating |
| url | http://www.sciencedirect.com/science/article/pii/S2352644025000950 |
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