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Updated: Jan 14, 2026
07:41
An Intramedullary Locking Nail for Standardized Fixation of Femur Osteotomies to Analyze Normal and Defective Bone Healing in Mice
Published on: November 13, 2016
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Extreme nailing: standardized definition and outcomes.
Abhishek Ganta1,2, Fiona Cherry3, Nirmal Tejwani3
1New York University Langone Medical Center, New York, USA. abhishek.ganta@nyulangone.org.
Summary
Extreme tibial nailing is feasible for fractures extending to the bone ends. This intramedullary nailing technique shows acceptable alignment and healing outcomes, despite some complications.
Area of Science:
- Orthopedic Surgery
- Trauma Surgery
- Bone Fracture Management
Background:
- Tibial fractures extending to the proximal or distal ends pose treatment challenges.
- Intramedullary nailing is a common treatment, but its feasibility in extreme cases requires definition.
Purpose of the Study:
- To define "extreme tibial nailing" and assess its feasibility.
- To evaluate outcomes of tibial intramedullary nailing for fractures involving the nail's locking zone.
Main Methods:
- Retrospective review of 555 tibia fractures from a single academic center.
- Defined "extreme nailing" as fractures within the proximal/distal 25% of the tibia, involving the nail's locking bolt zone.
- Excluded patients with supplemental periarticular plating.
Main Results:
- Twenty-five "extreme IMN" cases were analyzed (mean age 45.8 years, 72% female).
- High-energy (50%+) and open fractures (40%) were common.
- Complications included fracture-related infection (12%), nonunion (20%), and reoperation (32%). Malalignment occurred in 8%.
Conclusions:
- Tibial intramedullary nailing is effective for extreme tibial fractures extending to articular surfaces.
- The majority of patients achieved acceptable alignment and radiographic union within 6 months.
- This technique demonstrates feasibility with manageable complication rates.
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