Proximal tibia fractures and intramedullary nailing: The impact of nail trajectory to varus/valgus deformity.

摘要

Although intramedullary nailing has been the treatment of choice for diaphyseal tibial fractures,1"6 its role in the management of fractures occurring at the proximal tibial metaphysis remains controversial, as high complication rates that mostly refer to unsuccessful reduction and malalignment have been reported.7'8 To overcome these problems and improve outcomes, certain modifications to the standard operative technique have been proposed, such as the use of blocking screws, additional buttress plate, different patient positioning, and extended parapatellar or retropatellar approaches. Remarkably, the role of location of the entry portal for the nail in the coronal plane in achieving and maintaining fracture reduction has not been thoroughly investigated.