{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T03:53:52Z","timestamp":1789617232195,"version":"build-2803163510"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Summary:<\/jats:title>\n          <jats:p>Periprosthetic tibial shaft fractures below total knee arthroplasty (TKA) are relatively rare, with an incidence of approximately 1%. However, as the rates of arthroplasty increase, orthopaedic surgeons are likely to see a corresponding increase in these types of fractures. Native tibial shaft fractures are routinely treated with either nails or plates, and the success of intramedullary nailing of tibial shaft fractures has been well described in the literature. In this article, we seek to describe a case series of tibial shaft fractures in patients with ipsilateral TKA treated with infrapatellar intramedullary nailing. We will focus on preoperative considerations including templating and measurement of the anterior cortical implant distance on the lateral radiograph to ensure space for safe nail passage. We will also discuss intraoperative technical tricks, including Kirschner wire insertion for sounding the start point, utilization of the curved awl, use of hand reamers, and rotation of the nail to bypass the implant. Using meticulous preoperative planning and technical intraoperative tricks, patients with tibial shaft fractures below TKA may be successfully treated with intramedullary nailing.<\/jats:p>","DOI":"10.1097\/bot.0000000000002367","type":"journal-article","created":{"date-parts":[[2022,3,2]],"date-time":"2022-03-02T14:12:56Z","timestamp":1646230376000},"page":"e437-e441","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":7,"title":["Preoperative and Intraoperative Considerations Using Intramedullary Nails for the Treatment of Tibial Shaft Fractures Below Total Knee Arthroplasty"],"prefix":"10.1097","volume":"36","author":[{"given":"Nicole M.","family":"Stevens","sequence":"first","affiliation":[{"name":"NYU Langone Hospital-Long Island, Mineola, NY; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew F.","family":"Tyler","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center, Nashville, TN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip M.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center, Nashville, TN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Stinner","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center, Nashville, TN."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20250614","doi-asserted-by":"crossref","first-page":"780","DOI":"10.2106\/00004623-200704000-00012","article-title":"Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030","volume":"89","author":"Kurtz","year":"2007","journal-title":"J Bone Joint Surg Am"},{"key":"R2-20250614","first-page":"91","article-title":"Treatment of periprosthetic tibial fractures","author":"Hanssen","year":"2000","journal-title":"Clin Orthop Relat 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alternative method of treatment: a case report","volume":"25","author":"Zafra-Jim\u00e9nez","year":"2011","journal-title":"J Orthop Trauma"},{"key":"R12-20250614","first-page":"E111","article-title":"Tibial fracture after total knee arthroplasty treated with retrograde intramedullary fixation","volume":"36","author":"Doulens","year":"2007","journal-title":"Am J Orthop (Belle Mead NJ)"},{"key":"R13-20250614","doi-asserted-by":"crossref","first-page":"e409","DOI":"10.1097\/BOT.0000000000000656","article-title":"Suprapatellar nailing of Tibial shaft fractures in total knee arthroplasty","volume":"30","author":"Woyski","year":"2016","journal-title":"J Orthop Trauma"}],"container-title":["Journal of Orthopaedic 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