Which is superior in the treatment of AO Type 42A tibial shaft fracture? A comparison of talon intramedullary nailing and conventional locked intramedullary nailing

BACKGROUND: This study aimed to compare the clinical and radiological outcomes of conventional locked intramedullary nailing (IMN) and talon IMN in AO Type 42A tibial fractures.
METHODS: A total of 93 patients with AO Type 42A fracture were retrospectively analyzed. The patients were divided into two groups: Those treated with conventional IMN (Group 1), and those treated with talon distal locked nailing (Group 2). The patients were statistically compared in terms of age, sex, mechanism of injury, follow-up time, time to union, smoking status, presence of open fracture, presence of concomitant fibula fracture, development of malunion and nonunion, and the number of intraoperative fluoros-copy shots captured. All patients were evaluated with American Orthopaedic Foot and Ankle Society and Tegner Lysholm scores for clinical outcomes.
RESULTS: A total of 93 patients (68 men and 35 women) participated in the study. Group 1 consisted of 35 (71.4%) men and 14 (28.6%) women, a total of 49 patients, while Group 2 consisted of 33 (75%) men and 11 (25%) women, a total of 44 patients. There were no significant differences between the two groups in terms of age, sex, mechanism of injury, follow-up times, smoking status, concomitant fibula fracture, presence of malunion, and presence of open fracture (p>0.05). However, there were significant differences between both groups in terms of time to union, nonunion rate, and the number of fluoroscopy shots captured (p<0.05). American Orthopaedic Foot and Ankle Society and Tegner Lysholm score were analyzed and compared, no statistically differences were found (p=0.786 and p=0.764).
CONCLUSION: Although talon IMN reduces radiation exposure, locked conventional IMN has lower nonunion rates and achieves union faster.

AO Type 42A tibia þaft kýrýklarýnda hangisi daha üstün? Talonlu intrameduller çivi ile kilitli konvansiyonel intramedüller çivinin karþýlaþtýrýlmasý

AMAÇ: Çalýþmadaki amacýmýz Tibia AO Type 42A kýrýklarda konvansiyonel kilitli intramedüller çiviler ile talon kilitlemeli intramedüllerin klinik ve radyolojik sonuçlarýný kýyaslamaktýr.
GEREÇ VE YÖNTEM: AO Type 42 A kýrýðý olan 93 hasta geriye dönük olarak incelendi. Hastalar konvasiyonel intramedüller çivi yapýlanlar (Grup 1) ve talonlu distal kilitleme yapýlanlar (Grup 2) olarak ikiye ayrýlmýþlardýr. Hastalar yaþ, cinsiyet, yaralanma mekanizmasý, takip süresi, kaynama zamaný, sigara içiciliði, açýk kýrýk varlýðý, eþlik eden fibula kýrýðý varlýðý, malunion, nounion geliþmesi ve operasyon sýrasýnda çekilen skopi sayýlarý açýsýndan istatistiki olarak karþýlaþtýrýldý. Hastalar American Orthopaedic Foot and Ankle Society and Tegner Lysholm skorlarý hesaplanarak klinik skorlar açýsýndan da kýyaslandý.
BULGULAR: Çalýþmaya 68 erkek ve 35 kadýn olmak üzere 93 hasta alýndý. Grup 1 35 (%71.4) erkek, 14 (%28.6) kadýn olmak üzere 49 hasta ve grup 2 33 (%75) erkek, 11 (%25) kadýn olmak üzere 44 hastadan oluþmaktaydý. Her iki grup arasýnda yaþ, cinsiyet, yaralanma mekanizmasý takip süreleri, sigara içiciliði, eþlik eden fibula kýrýðý, malunion varlýðý, açýk kýrýk varlýðý açýsýndan anlamlý fark saptanmamýþtýr (p>.05). Her iki grup arasýnda kaynama zamaný, nonunion ve skopi sayýlarý açýsýndan anlamlý fark olduðu görüldü (p<.05). American Orthopaedic Foot and Ankle Society and Tegner Lysholm skoru açýsýndan her iki grup arasýnda istatistiki olarak anlamlý fark bulunamadý (p=0.786 and p=0.764).
TARTIÞMA: Talonlu intramedüller çiviler radyasyon maruziyetini azaltmaktadýr fakat kilitli konvansiyonel intramedüller çivilerde nonunion oranlarý daha düþüktür ve kaynama daha erken saðlanmaktadýr.