Intramedullary nailing of extra-articular proximal tibia fractures.

Timothy G. Hiesterman, Babar X. Shafiq, Peter A. Cole

Research output: Contribution to journalReview articlepeer-review

62 Scopus citations


Tibial fractures are the most common long bone fractures. Extra-articular proximal tibia fractures account for approximately 5% to 11% of all tibial shaft fractures. The benefits of intramedullary nailing of these fractures include load sharing, sparing of the extraosseous blood supply, and avoidance of additional soft-tissue dissection, thereby minimizing the risk of postoperative complications. A significant rate of malalignment has been reported with intramedullary nailing of proximal tibia fractures, however. Malalignment typically presents as apex anterior and valgus angulation. Several nailing methods and reduction techniques have been developed to minimize this complication, including the use of a proper starting point and insertion angle, blocking screws, unicortical plates, a universal distractor, and alternative positioning and approaches. Use of one or more of these techniques has resulted in a reported average malreduction rate of 8.2%.

Original languageEnglish (US)
Pages (from-to)690-700
Number of pages11
JournalThe Journal of the American Academy of Orthopaedic Surgeons
Issue number11
StatePublished - Nov 2011


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