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14 September 2023 : Clinical Research  

[In Press] Improved Outcomes in Distal Tibial Non-Union: A Retrospective Study of 8 Patients Treated with Distal Tibial Nail and Screw Fixation

Celil Alemdar ORCID logo1ABCDEFG, Sait Anıl Ulus ORCID logo2ABCDEF, Ramazan Atiç ORCID logo2ABCDEG, Sebahattin Demir ORCID logo3ABCEG, İlknur Topal ORCID logo4ABCEF, Şafak Sayar ORCID logo5ABCEF

DOI: 10.12659/MSM.942207

Med Sci Monit In Press; DOI: 10.12659/MSM.942207  

Available online: 2023-09-14, In Press, Corrected Proof

Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule


Non-union of distal tibia fractures is a challenge in orthopedic surgery and can be due to open fractures, osteopenia, infection, or failure of surgical devices. This retrospective study aimed to describe 8 patients with non-union of distal tibial fractures treated with distal tibial nail and screw fixation.
According to the Gustilo-Anderson classification, 3 patients had type 2 open fractures, 1 had a type 3 open fracture, 1 had a type 1 open fracture, and 3 had closed fractures. The Association of Osteosynthesis AO classified 4 patients as A2, 2 as B2, and 2 as C2. Seven patients received distal supporting bolt-locking-screw nails (DSBLS) and 1 received DSBLS nail and plate in their most recent operation. Clinical outcomes were evaluated with American Orthopaedic Foot and Ankle Society (AOFAS) and Olerud-Molander scores.
All 8 patients were male, with a mean age of 35.5±14.6 years. Six patients had atrophic non-union, 1 had hypertrophic non-union, and 1 had infected non-union. Union was achieved in all patients. The average union time was 25.1 (range, 12-60) months, and the follow-up duration was 3.6 (range, 2-6) years. The mean Olerud-Molander score was 92.5 (range 85-100), and the mean AOFAS score was 91.2 (range, 85-100). There was no evidence of rotational deformity or shortening.
Distal tibial non-unions benefit from nails with DSBLS system due to their excellent biomechanical properties. These nails facilitate union and allow patients to bear weight early in the postoperative period, enabling a quicker return to normal activities.

Keywords: Pseudarthrosis; Fracture Fixation, Intramedullary; Tibia


01 September 2023 : Editorial  

Editorial: A Rapid Global Increase in COVID-19 is Due to the Emergence of the EG.5 (Eris) Subvariant of Omicron SARS-CoV-2

Dinah V. Parums
Science Editor, Medical Science Monitor, International Scientific Information, Inc., Melville, NY, USA

DOI: 10.12659/MSM.942244

Med Sci Monit 2023; 29:e942244


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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750