Determination of the Best Method of Tibial Nail Length Estimation in Patients with Tibia Fracture

Tibia fractures are the most common long bone fracture. Due to minimal soft tissue and its blood supply, inadequate treatment of injuries could be a major cause of morbidity and disability. The intramedullary nail is the preferred method of treatment; however, despite all previous studies, no accurate method to measure nail length prior to surgery exists as yet. Due to the importance of this issue in stability and alignment and reduction of operation time, in this study, we compared several methods of measuring tibia nail length. This was a cross-sectional study in which the nail length was estimated using different methods such as X-ray of the opposite leg, tubercle-medial malleolar distance (TMD), and olecranon to fifth metacarpal distance. In addition, the length of the tibia canal was measured using a metal rod during the surgery. Subsequently, the obtained results were compared. None of the studied methods showed a significant difference between the estimation and the length of used nail. However, the results from the combination of the two methods of olecranon to fifth metacarpal and X-ray of the opposite leg had the closest correlation with the length of used nail. The aim of this study was to determine the best method of preoperative estimation of the length tibia canal for the reduction of operative time and better fracture fixation. Among these methods, the combination of olecranon to fifth metacarpal and opposite leg X-ray showed the strongest correlation.