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Ulus Travma Acil Cerrahi Derg. 2019 May;25(3):293-297. doi: 10.14744/tjtes.2019.86613.

Finite element analysis of the effect of intramedullary nail compression amount on fracture union in distal tibial diaphyseal fractures.

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Department of Orthopedics and Traumatology, University of Health Sciences Antalya Training and Research Hospital, Antalya-Turkey.



The objective of this study was to investigate the relationship between the stress values on the fracture surface and union periods seen in cases of different compression amounts used to manage distal tibial diaphyseal fractures treated with intramedullary nailing (IMN).


Ninety-five patients (mean age: 33.99+-10.65 years; male: n=78, female: n=17) with tibial shaft fracture were included in the study. The patients were divided into 3 groups: No compression was used in Group 1 (33 patients), and dynamic compressive fixation was performed with IMN in Group 2 (1 mm, 32 patients) and Group 3 (1.5 mm, 30 patients). A finite element study was performed for Group 2 and Group 3.


The average time to achieve radiological union was 16.08+-2.02, 13.54+-1.52, and 12.56+-1.73 weeks in Groups 1, 2, and 3, respectively. Comparatively, the union period in the non-compression group was significantly longer (p<0.001). The functional results were evaluated as excellent in 28 (85%) patients and good-medium in 5 (15%) in Group 1, excellent in 27 (92%) and good-medium in 5 (8%) in Group 2, and excellent in 26 (92%) and good-medium in 4 (8%) in Group 3.


IMN is a highly effective treatment method for tibial shaft fracture.

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