Tibial Nail Removal in Younger and Active Patients with Discomfort: A Cohort Study of 40 Patients

Katrine Borum, Kristoffer Borbjerg Hare, Peter Jessen

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Introduction: The benefit of subsequent removal of an intramedullary tibial nail after osteosynthesis of a tibial fracture is uncertain. Studies on removal outcome are both few and negative. The aim of this study was to evaluate the change in pain, physical activity and employment status after implant removal in patients with a tibial fracture primarily treated with an intramedullary nail. Furthermore, possible predictors for implant removal were identified. Methods: The study was a retrospective cohort study with written follow-up. We collected data on all patients with a tibia fracture treated with insertion of a tibial nail at the orthopedic department in Slagelse, Denmark from 2009-2011. Medical journals for each patient were reviewed and a questionnaire was mailed to all patients to evaluate change in pain, physical activity and employment status. Results: Forty patients were included and 21 had implant removal. Implant removal reduced pain scores at rest (3.5 ± 0.6 to 1.2 ± 0.4; p < 0.001) and stress (6.6 ± 0.5 to 3.7±0.6; p < 0.001). There was no significant increase in physical activity although a trend was seen towards regaining pre-fracture level. Young age was slightly associated with implant removal but not statistical significant. Conclusion: In our study, younger patients with persistent pain after primary treatment of a tibial fracture with an intramedullary tibial nail showed reduced pain and improved physical activity after removal of the tibial nail or locking screws only.
TidsskriftJournal of Exercise, Sports and Orthopedics
StatusUdgivet - 8. apr. 2016