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Retrograde Tibial Nailing: A Case Study.

Steven Yacovelli¹, Carolina Stocchi, David Forsh

¹Department of Orthopedics, Icahn School of Medicine, New York City, NY.

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|April 25, 2025

Summary

Retrograde tibial nailing, a novel surgical technique, offers a viable alternative for treating distal tibia and fibula fractures when standard methods are not feasible. This case demonstrates its technical possibility and positive outcomes.

Keywords:

adult female retrograde nailing retrograde tibial nail tibial shaft fracture

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Area of Science:

Orthopedic Surgery
Trauma Management
Skeletal Repair

Background:

Distal tibia and fibula fractures are common injuries.
Antegrade intramedullary nailing is the standard treatment.
Alternative techniques are needed when standard approaches are challenging.

Purpose of the Study:

To report a case of successful retrograde tibial nailing.
To evaluate the feasibility and outcomes of this technique.
To discuss its potential as an alternative surgical option.

Main Methods:

A 28-year-old female patient with a left displaced distal tibia and fibula fracture.
Closed reduction of the fracture.
Retrograde intramedullary osteosynthesis using a nail designed for antegrade insertion with custom techniques.

Main Results:

The retrograde tibial nailing procedure was technically successful.
The patient achieved good clinical outcomes.
The technique demonstrated feasibility in this case.

Conclusions:

Retrograde tibial nailing is a technically possible and effective alternative for distal tibia and fibula fractures.
It requires off-label use and custom techniques currently.
Further investigation and potentially a dedicated implant could establish it as a standard option.