|
Year |
2006 |
|---|---|
|
Question Number |
275 |
|
Category |
Musculoskeletal Trauma |
Question
The advantage of using blocking screws during intramedullary nailing of metaphyseal tibial fractures include all of the following EXCEPT
1- facilitate reduction
2- maintain reduction
3- enhance construct stiffness
4- neutralize translational forces
5- diminish the risk of nail failure
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Answer (click for answer)
The answer is 5
Proximal 1/3 tibial shaft fractures are prone to angular and translational deformities (see answer above for question #269). Blocking screws are commonly used in proximal 1/3 extra-articular tibial shaft fractures in order to help facilitate reduction and maintain reduction. Blocking screws can also minimize translational forces from shifting the fracture fragments into a malaligned position. A recent cadaveric study revealed that medial and lateral blocking screws can also increase the primary stability of the distal and proximal metaphyseal fractures after nailing (Krettek et al, JOT, 1999). Although blocking screws can improve the strength of the bone-implant complex, they will not alter the stiffness or failure properties of the nail which is an inherent property of the device.
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