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Defining the ideal 'nail exit path' of a tibial intramedullary nail - a computed tomography analysis of 860 tibiae.

Trompeter, A; Williamson, M; Bates, P; Petersik, A; Kelly, M (2021) Defining the ideal 'nail exit path' of a tibial intramedullary nail - a computed tomography analysis of 860 tibiae. J Orthop Trauma, 35 (11). e392-e396. ISSN 1531-2291 https://doi.org/10.1097/BOT.0000000000002098
SGUL Authors: Trompeter, Alex Joel

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Abstract

OBJECTIVES: To identify the ideal distal nail position in the distal tibia, using computed tomography (CT) analysis. METHODS: 3D models of 860 left tibiae were analysed using the Stryker Orthopaedic Modelling and Analytics software (SOMA, Stryker, Kiel, Germany). The nail axis was defined by seven centre points at the middle of the inner cortical boundary. Where this line fell relative to the centre of the tibial plafond in both the anteroposterior and mediolateral planes was calculated. RESULTS: The mean mediolateral offset of the tibial nail exit path was 4.4 ± 0.2mm (95% confidence interval) lateral to the centre of the tibial plafond. The mean anteroposterior offset of the tibial nail exit path was 0.6 ± 0.1mm anterior to the centre of the tibial plafond. CONCLUSIONS: We have presented an anatomic study analysing the ideal nail exit path using CT scans of 860 tibiae. We have defined the ideal nail exit path of a tibial nail is lateral with respect to the centre of the tibial plafond. This is supported by previous clinical studies and has significant implications for preventing malalignment when treating distal tibial fractures with intramedullary nailing. LEVEL OF EVIDENCE: Level IV. See Instructions for Authors for a complete description of levels of evidence.

Item Type: Article
Additional Information: This is a non-final version of an article published in final form in Trompeter, A; Williamson, M; Bates, P; Petersik, A; Kelly, M (2021) Defining the ideal 'nail exit path' of a tibial intramedullary nail - a computed tomography analysis of 860 tibiae. J Orthop Trauma, 35 (11). e392-e396.
Keywords: 1103 Clinical Sciences, Orthopedics
SGUL Research Institute / Research Centre: Academic Structure > Institute of Medical & Biomedical Education (IMBE)
Journal or Publication Title: J Orthop Trauma
ISSN: 1531-2291
Language: eng
Dates:
DateEvent
November 2021Published
2 March 2021Published Online
1 March 2021Accepted
Publisher License: Publisher's own licence
PubMed ID: 33675627
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/113036
Publisher's version: https://doi.org/10.1097/BOT.0000000000002098

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