ABSTRACT
OBJECTIVE: Although various methods have been identified for the appropriate tibial nail length, there are disadvantages such as extra time, radiation exposure, and additional cost. We aimed to predict the ideal length of the nail according to the patient's height and shoe size in the preoperative period to eliminate these disadvantages. MATERIALS AND METHODS: Between January 2018 and August 2023, the height and shoe size data of 71 patients who were diagnosed with tibial shaft fracture and had tibia intramedullary nail fixation were determined. A linear regression model was applied to the normally distributed data. The correlation coefficient between the variables was evaluated according to the Pearson correlation coefficient. RESULTS: While 1 1-centimeter (cm) increase in patient height causes an increase of 3.2 millimeters (mm) in nail length, it was found that it alone contributed by 89% to predicting the ideal nail length (p<0.001). An increase of 1 unit in shoe size (EU) causes an increase of 9 mm in nail length; its contribution to predicting the ideal nail length alone is 84% (p<0.001). In the evaluation of the patient's height and shoe size together, it was observed that they jointly contributed 91% to the accurate estimation of the nail length (p<0.001). CONCLUSION: It may be risky to determine the tibial nail length only by shoe size or the patient's height. However, the correlation between them is strong. Therefore, by estimating nail lengths before the operation, the ideal nail length can be found by making fewer fluoroscopy checks during the operation.
ABSTRACT
PURPOSE: During fracture fixation, the size of tibial nail is a vital factor affecting the outcomes and thus preoperative estimation of tibial nail length is very important. This study aims to find out whether "olecranon to 5th metacarpal head" (O-MH) measurement can be used to reliably predict the tibial nail length. METHODS: This was a cross sectional study involving 100 volunteers. Measurements were done and recorded by two observers on two separate occasions. Tibial nail length estimation measurement was done from highest point of tibial tuberosity to the tip of the medial malleolus (TT-MM). O-MH measurement was taken from tip of olecranon to the tip of 5th metacarpal head with wrist in neutral position and hand clenched. Statistical analysis was done to find out correlation between two measurements and influence of age, gender and body mass index on them. RESULTS: Paired t-test showed no systematic error between the readings. Intraclass correlation coefficient showed strong agreement in inter and intra observer settings. Strong correlation was found between the TT-MM & O-MH measurements using Pearson's correlation coefficient test (r = 0.966). Hierarchical regression analysis showed age, gender and BMI have no statistically significant bearings on these measurements and their correlations. CONCLUSION: O-MH measurement is a useful and accurate means of estimating tibial nail length preoperatively.
Subject(s)
Anthropometry , Metacarpal Bones/anatomy & histology , Nails/anatomy & histology , Tibia/anatomy & histology , Female , Humans , MaleABSTRACT
Purpose:@#During fracture fixation, the size of tibial nail is a vital factor affecting the outcomes and thus preoperative estimation of tibial nail length is very important. This study aims to find out whether "olecranon to 5th metacarpal head" (O-MH) measurement can be used to reliably predict the tibial nail length. @*Methods:@#This was a cross sectional study involving 100 volunteers. Measurements were done and recorded by two observers on two separate occasions. Tibial nail length estimation measurement was done from highest point of tibial tuberosity to the tip of the medial malleolus (TT-MM). O-MH measurement was taken from tip of olecranon to the tip of 5th metacarpal head with wrist in neutral position and hand clenched. Statistical analysis was done to find out correlation between two measurements and influence of age, gender and body mass index on them. @*Results:@#Paired t-test showed no systematic error between the readings. Intraclass correlation coefficient showed strong agreement in inter and intra observer settings. Strong correlation was found between the TT-MM & O-MH measurements using Pearson's correlation coefficient test (r = 0.966). Hierarchical regression analysis showed age, gender and BMI have no statistically significant bearings on these measurements and their correlations. @*Conclusion:@#O-MH measurement is a useful and accurate means of estimating tibial nail length preoperatively.