A Tip to Make Your IM Tibial Nails More Resistant to Load

Lab studies rarely give us something we can use today; this one does — a simple suggestion with no obvious disadvantages

What’s the Claim?

We rarely cover biomechanical studies because they’re so rarely clinically relevant. This one seems like an exception, its message has good face validity, and, as CORRelations’ advisor in Fractures & Trauma, Jaimo Ahn MD, says, “It takes only a second and a few extra taps . . .”

A mechanical study compared intramedullary tibial nailing in which nails with one or two distal interlocking screws either were placed all the way down to the physeal scar above the ankle, or just short of the physeal scar (with two interlocks), and found that IM tibial nails placed so the distal tip went all the way down to the physeal scar demonstrated modestly less deformation under load than did those in which the nail tip stopped short of (was cephalad or proximal to) the physeal scar.

How’s It Stack Up?