Study Results
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Basic Information
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COMPLETED
50 participants
OBSERVATIONAL
2006-01-31
2009-12-31
Brief Summary
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Detailed Description
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We evaluated postoperative outcome results of 50 patients in the last 3 years with healed fractures initially treated with intramedullary (IM) reamed nails with 2 or 3 interlocking screws on both parts of the nail and with the use of medial peritendinous incision for nail entry portal. Patients marked a point on the visual analog scale (VAS) that corresponded to the level of postoperative AKP felt. Two groups of patients were formed on the basis of AKP (pain level was neglected): groups A and B, with and without pain, respectively.
We found that the difference between the two groups concerning NP measurements was statistically significant, but not concerning NT measurements (P \< 0.05). Patients were classified by pain with high accuracy (98%) according to a classification tree.
We conclude that the symptoms of AKP did not appear if the tip of the nail position was more than 6.0 mm from the NP and more than 2.6 mm from the NT. However, for better evaluation of these results it will be necessary to examine more postoperative patients with AKP.
Conditions
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Study Design
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COHORT
PROSPECTIVE
Study Groups
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Tibial shaft fractures
Patients had tibial shaft fractures in the last 3 years. All were treated with intramedullary (IM) reamed nails with 2 or 3 interlocking screws.
Tibial intramedullary nailing
Patients' operations were performed using the peritendinous approach. A medial longitudinal incision was made, with care being taken not to damage the patellar tendon or its sheath. Standard proximal and distal locking screws were used. All patients were given postoperative instructions for thigh muscle rehabilitation and the same physiotherapy was performed after IM nailing during hospitalization. Nails were removed from some of the patients with the presence of knee pain or pain at the insertion points of the locking screws, however, no nails were removed earlier than one year postoperatively. Proof of the healed bone fracture was confirmed by radiologic examination.
Interventions
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Tibial intramedullary nailing
Patients' operations were performed using the peritendinous approach. A medial longitudinal incision was made, with care being taken not to damage the patellar tendon or its sheath. Standard proximal and distal locking screws were used. All patients were given postoperative instructions for thigh muscle rehabilitation and the same physiotherapy was performed after IM nailing during hospitalization. Nails were removed from some of the patients with the presence of knee pain or pain at the insertion points of the locking screws, however, no nails were removed earlier than one year postoperatively. Proof of the healed bone fracture was confirmed by radiologic examination.
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* fracture treatment with intramedullary nailing with 2 or 3 interlocking screws on both ends of the nail
Exclusion Criteria
ALL
Yes
Sponsors
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University of Zagreb
OTHER
Responsible Party
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National Health Insurance
Principal Investigators
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Nikica Darabos, MD, PhD
Role: PRINCIPAL_INVESTIGATOR
University of Zagreb School of Medicine
Locations
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University of Zagreb School of Medicine, Department of Traumatology
Zagreb, , Croatia
Countries
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Other Identifiers
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AKP
Identifier Type: -
Identifier Source: org_study_id
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