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            [0] => The impact of the nail diameter on bone healing and postoperative complications in distal tibial fractures
        )

    [etablissement] => Array
        (
            [0] => Orthopedics and traumatology department. Hospital of Mohamed Taher Maamouri. Nabeul
        )

    [nom] => Array
        (
            [0] => Jlidi
        )

    [prenom] => Array
        (
            [0] => Mohamed
        )

    [email] => Array
        (
            [0] => medjlidi@hotmail.fr
        )

    [telephone] => Array
        (
            [0] => 29030521
        )

    [auteurs] => Array
        (
            [0] => 
 
Nom prénom / Name Surname: Belkadhi Imen
Email: imen123belkadhi@gmail.com
Hôpital / Hospital: Hospital of Mohamed Taher Maamouri

 
Nom prénom / Name Surname: Bouaicha Walid
Email: walid_bouaicha@yahoo.fr
Hôpital / Hospital: Hospital of Mohamed Taher Maamouri

 
Nom prénom / Name Surname: Lamouchi Mouldi
Email: hlamouchi92@gmail.com
Hôpital / Hospital: Hospital of Mohamed Taher Maamouri

 
Nom prénom / Name Surname: Mars Houssem
Email: houssemmars@gmail.com
Hôpital / Hospital: Hospital of Mohamed Taher Maamouri

 
Nom prénom / Name Surname: Zoghlami Elyes
Email: zelyes46@gmail.com
Hôpital / Hospital: Hospital of Mohamed Taher Maamouri

 
Nom prénom / Name Surname: Daas Selim
Email: selimdaas@yahoo.fr
Hôpital / Hospital: Hospital of Mohamed Taher Maamouri

        )

    [mots_cles] => Array
        (
            [0] => Intramedullary nailing;
nail diameter;
Distal tibia fracture;
fracture healing;
Malunion;
nonunion;

        )

    [event-id] => Array
        (
            [0] => 3663
        )

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            [0] => 1
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            [0] => none
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    [user_email] => Array
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            [0] => medjlidi@hotmail.fr
        )

    [specialite] => Array
        (
            [0] => Chirurgie orthopédique et traumatologique
        )

    [pays] => Array
        (
            [0] => Tunisie
        )

    [texte_abs] => Array
        (
            [0] => Introduction:
Intramedullary nailing (IMN) is considered the standard surgical treatment for tibial shaft fracture. However, the choice between large and small size of nail diameter remains controversial.
The aim of this study is to assess the relevance of nail diameter in bone healing and postoperative complications in distal tibial fractures. 
Methods: 
 It is a retrospective study including patients treated by IMN for a distal tibial fracture in our department between January 2013 and December 2021.
The patients were divided into two groups based on nail size diameter:
Group A treated with a 09 mm nail diameter and group B treated with 10 mm nail diameter. 
Radiological outcomes and failure rates (delay, malunion and non-union) were compared.
Results:
A total of 90 patients were included in the study with a minimum of 12 months follow-up. The average age of the patients was 45 years (range=19- 91). Males were  the most affected  (72.2% of cases).
Group A included 50 patients (55%), the average age was 45 years with male predominance (72%).
Group B included 40 patients (45%) with mean of age was 44.5 years. Male were more affected (72.5%)
Malunion was observed in 38.8 % in total cases: 32% in group A (n=16) and 47.5% in group B (n=19) without significant difference (p=0.192).
The overall union rate was 86.7% (n = 83).
In the group A, two patients developed nonunion (4%), while in group B, five patients were complicated by nonunion (12.5%).
 No significant differences in union rate or time to healing were observed between the two groups (p=0.136).
Conclusion :
In our retrospective cohort study, the rate of union and time to union were unaffected by the use of different nail size. Our finding indicate that distal tibial fractures  can be treated by a standard 09mm intramedullary nail . 
While the largest size nail have the advantage, biomechanically, to minimize fracture site movement, it presents more risks ,compared to small nail, including higher blood loss and longer operative times due to the need for more extensive reaming
        )

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