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%.





Polls results
1

On a scale of 1 to 10, rate how much this article will change your clinical practice?

NO change
BIG change
84% Article relates to my practice (11/13)
7% Article does not relate to my practice (1/13)
7% Undecided (1/13)
2

Will this article lead to more cost-effective healthcare?

69% Yes (9/13)
15% No (2/13)
15% Undecided (2/13)
3

Was this article biased? (commercial or personal)

0% Yes (0/13)
84% No (11/13)
15% Undecided (2/13)
4

What level of evidence do you think this article is?

15% Level 1 (2/13)
23% Level 2 (3/13)
61% Level 3 (8/13)
0% Level 4 (0/13)
0% Level 5 (0/13)