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Apex anterior and varus
10%
223/2328
Apex anterior and valgus
82%
1900/2328
Apex posterior and varus
2%
40/2328
Apex posterior and valgus
4%
97/2328
Rotational
3%
60/2328
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Proximal tibial shaft fractures treated with intramedullary nails are most commonly malreduced with apex anterior and valgus deformities. Several techniques are available to overcome this malalignment: proximal and lateral nail starting point, usage of a femoral distractor or temporary plating, suprapatellar nailing, and lateral parapatellar approaches. A final technical trick is the usage of blocking (Poller) screws - the referenced article by Ricci et al had 100% correction and maintenance of reduction with usage of blocking screws without other adjunct techniques. They report a union rate of >90% in this small series.
4.1
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