Distal tibial fracture below a total knee arthroplasty: Retrograde intramedullary nailing as an alternative method of treatment: A case report

José A. Zafra-Jiménez, Juan Abelardo Augusto Pretell, Carlos Resines-Erasun

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

An 85-year-old woman with a history of insulin-dependent diabetes mellitus, hypertension, and chronic venous insufficiency with underlying venous stasis who sustained a fall in her house presented to the emergency room with a displaced distal diaphyseal tibial fracture and a stable total knee arthroplasty. At her third day of admission, an intramedullary nail was inserted in a retrograde fashion through the calcaneus and talus into her tibial shaft to stabilize the fracture; there were no postoperative complications. Three years after surgery, the patient remains pain-free, the fracture had united, and her functional status is the same as it was before the fracture. There are different options for solving these types of fractures. Nonoperative, external fixation, conventional or locking plates and antegrade and retrograde intramedullary nailing could be used; however, they should be weighed against the particular issues of the patient involved. We think that a retrograde nailing technique through the calcaneotalotibial axis could be an alternative method for these types of fractures in a fragile patient with important comorbidities with few complications and good functional outcome.

Original languageEnglish (US)
JournalJournal of Orthopaedic Trauma
Volume25
Issue number7
DOIs
StatePublished - Jul 2011
Externally publishedYes

Fingerprint

Intramedullary Fracture Fixation
Knee Replacement Arthroplasties
Tibial Fractures
Talus
Calcaneus
Venous Insufficiency
Nails
Type 1 Diabetes Mellitus
Hospital Emergency Service
Comorbidity
Therapeutics
Hypertension

Keywords

  • calcaneus
  • intramedullary nail
  • Periprosthetic fracture
  • retrograde nailing technique
  • total knee arthroplasty

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

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title = "Distal tibial fracture below a total knee arthroplasty: Retrograde intramedullary nailing as an alternative method of treatment: A case report",
abstract = "An 85-year-old woman with a history of insulin-dependent diabetes mellitus, hypertension, and chronic venous insufficiency with underlying venous stasis who sustained a fall in her house presented to the emergency room with a displaced distal diaphyseal tibial fracture and a stable total knee arthroplasty. At her third day of admission, an intramedullary nail was inserted in a retrograde fashion through the calcaneus and talus into her tibial shaft to stabilize the fracture; there were no postoperative complications. Three years after surgery, the patient remains pain-free, the fracture had united, and her functional status is the same as it was before the fracture. There are different options for solving these types of fractures. Nonoperative, external fixation, conventional or locking plates and antegrade and retrograde intramedullary nailing could be used; however, they should be weighed against the particular issues of the patient involved. We think that a retrograde nailing technique through the calcaneotalotibial axis could be an alternative method for these types of fractures in a fragile patient with important comorbidities with few complications and good functional outcome.",
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AU - Pretell, Juan Abelardo Augusto

AU - Resines-Erasun, Carlos

PY - 2011/7

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N2 - An 85-year-old woman with a history of insulin-dependent diabetes mellitus, hypertension, and chronic venous insufficiency with underlying venous stasis who sustained a fall in her house presented to the emergency room with a displaced distal diaphyseal tibial fracture and a stable total knee arthroplasty. At her third day of admission, an intramedullary nail was inserted in a retrograde fashion through the calcaneus and talus into her tibial shaft to stabilize the fracture; there were no postoperative complications. Three years after surgery, the patient remains pain-free, the fracture had united, and her functional status is the same as it was before the fracture. There are different options for solving these types of fractures. Nonoperative, external fixation, conventional or locking plates and antegrade and retrograde intramedullary nailing could be used; however, they should be weighed against the particular issues of the patient involved. We think that a retrograde nailing technique through the calcaneotalotibial axis could be an alternative method for these types of fractures in a fragile patient with important comorbidities with few complications and good functional outcome.

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KW - total knee arthroplasty

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