155 Tibial Malrotation Following Intramedullary Nailing: A Literature Review

Abstract Aim The use of intramedullary nail fixation remains the operation choice for managing unstable and displaced tibia diaphyseal fractures. literature shows that although commonly performed, there is not a standard approach when performing nailing tibia; it could be hypothesised this lack standardisation may contributing to noted complications. This systematic review will look into in all its parts, from identification patients through surgical procedure techniques finally intra- post-operative Method Preferred Reporting Items Systematic Reviews Meta-Analyses (PRISMA) guidelines were used. Search terms included “tibial nail” OR rod” IM interlock” AND “malrotation”, nailing” im “malrotation”. Results Eleven studies considered final analysis, with total number 425 fractures (n=429, mean ± 95% CI=39 (21.2–56.8)). All treated tibial devices, 110 showed some degree malrotation postoperatively (n=110, CI=10.1 (4.26–15.9)). Expressed as percentage, 34.1% had (mean CI: 34.1 (15.8–52)). Conclusions revealed are gaps management process these suggested using ‘Get It Right First Time’ (GIRFT), intraoperative assessment, validated assessment tools, imaging should used improve outcomes.