{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:46:27Z","timestamp":1787755587320,"version":"build-2784847793"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>A 49-year-old gentleman sustained a closed, right tibia peri-implant fracture with a bent intramedullary nail. This resulted in a 17\u00b0 valgus and 5\u00b0 recurvatum deformity with fracture at the distal third of the tibial shaft. The patient underwent closed manipulation with an F-Tool and was reviewed by our unit over the following year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This is the first case report of closed manipulation of a tibial fracture over a bent implant. This approach was successful in correcting deformity to within acceptable limits, achieved radiological union, and was associated with excellent patient-reported outcomes at all points of follow-up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.24.00379","type":"journal-article","created":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T14:03:10Z","timestamp":1737036190000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Closed Management of a Bent Tibial Nail: Can Revision Be Avoided?"],"prefix":"10.2106","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0946-4015","authenticated-orcid":false,"given":"Johanna J.","family":"Mousley","sequence":"first","affiliation":[{"name":"Northeast Health Wangaratta, VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1572-2358","authenticated-orcid":false,"given":"Richard","family":"Kjar","sequence":"additional","affiliation":[{"name":"Northeast Health Wangaratta, VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Reidy","sequence":"additional","affiliation":[{"name":"Northeast Health Wangaratta, VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7660-6415","authenticated-orcid":false,"given":"Anton","family":"Lambers","sequence":"additional","affiliation":[{"name":"Northeast Health Wangaratta, VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,1]]},"reference":[{"issue":"4","key":"bib1-20250116","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1016\/j.injury.2014.12.027","article-title":"Incidence and epidemiology of tibial shaft fractures","volume":"46","author":"Larsen","year":"2015","journal-title":"Injury."},{"issue":"8","key":"bib2-20250116","doi-asserted-by":"crossref","first-page":"e035404","DOI":"10.1136\/bmjopen-2019-035404","article-title":"The economic burden of infections following intramedullary nailing for a tibial shaft fracture in England","volume":"10","author":"Galvain","year":"2020","journal-title":"BMJ Open."},{"issue":"2","key":"bib3-20250116","first-page":"107","article-title":"Removal of a bent tibial intramedullary nail: a rare case report and review of the literature","volume":"14","author":"Aggerwal","year":"2011","journal-title":"Chin J Traumatol."},{"issue":"2","key":"bib4-20250116","first-page":"1","article-title":"Anatomic approach to the removal of A bent intramedullary nail in A refractured tibia minimising soft tissue and bone injury: a rare case report","volume":"19","author":"Buunaaim","year":"2012","journal-title":"J Inter Orthop Surg."},{"issue":"10","key":"bib5-20250116","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1007\/s00402-003-0576-y","article-title":"Unreamed tibia nail (UTN) bending: case report and problem solution","volume":"123","author":"Kelsch","year":"2003","journal-title":"Arch Orthop Trauma Surg."},{"issue":"8","key":"bib6-20250116","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1097\/00005131-199611000-00014","article-title":"Treatment of deformed tibial intramedullary nail: report of two cases","volume":"10","author":"Yip","year":"1996","journal-title":"J Orthop Trauma."},{"issue":"3","key":"bib7-20250116","doi-asserted-by":"crossref","first-page":"e0385","DOI":"10.2106\/JBJS.CC.18.00385","article-title":"Extraction of a bent tibial nail after refracture: a case report","volume":"9","author":"McChesney","year":"2019","journal-title":"JBJS Case Connect."},{"issue":"2","key":"bib8-20250116","doi-asserted-by":"crossref","first-page":"e19.00542","DOI":"10.2106\/JBJS.CC.19.00542","article-title":"Bent tibial nail with refracture: a cost-effective removal method: a case report","volume":"10","author":"Pathak","year":"2020","journal-title":"JBJS Case Connect."},{"key":"bib9-20250116","doi-asserted-by":"crossref","first-page":"2050313X231225338","DOI":"10.1177\/2050313X231225338","article-title":"Surgical management of tibia refracture with a bent intramedullary nail: a case report and review of the literature","volume":"12","author":"Bouaicha","year":"2024","journal-title":"SAGE Open MedCase Rep."},{"issue":"2","key":"bib10-20250116","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1007\/s00402-015-2360-1","article-title":"Removal of a bent intramedullary nail in lower extremity: report of two cases and review of removal techniques","volume":"136","author":"Kose","year":"2016","journal-title":"Arch Orthop Trauma Surg."},{"issue":"7","key":"bib11-20250116","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1007\/s00113-010-1856-y","article-title":"Verbogener intramedull\u00e4rer Tibiamarknagel nach erneutem Trauma. Removal of a bent intramedullary tibia nail: Case report and review of literature [in German]","volume":"114","author":"Wierer","year":"2011","journal-title":"Unfallchirurg."},{"issue":"3","key":"bib12-20250116","doi-asserted-by":"crossref","DOI":"10.2106\/JBJS.CC.23.00186","article-title":"Removal of a bent tibial intramedullary nail through osteotomy and partial sectioning: a case report","volume":"13","author":"Arif","year":"2023","journal-title":"JBJS Case Connector."},{"key":"bib13-20250116","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1016\/j.jor.2020.06.005","article-title":"Surgical management of angulated femoral intramedullary nails associated with closed fractures: a systematic review of the literature","volume":"21","author":"Dunleavy","year":"2020","journal-title":"J Orthop."},{"issue":"1","key":"bib14-20250116","first-page":"167","article-title":"In situ straightening of a bent tibiofemoral intramedullary nail: case report and review of the literature","volume":"41","author":"Shamrock","year":"2021","journal-title":"Iowa Orthop J."},{"issue":"3","key":"bib15-20250116","doi-asserted-by":"crossref","first-page":"e19.00615","DOI":"10.2106\/JBJS.CC.19.00615","article-title":"Closed management of a distal radius refracture through a bent volar plate: can an open procedure be avoided?: a case report","volume":"10","author":"Hall","year":"2020","journal-title":"JBJS Case Connect."},{"issue":"8","key":"bib17-20250116","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1007\/s00402-020-03608-y","article-title":"Results following prolonged recovery show satisfactory functional and patient-reported outcome after intramedullary nailing of a tibial shaft fracture: a prospective 5-year follow-up cohort study show satisfactory functional and patient-reported outcome after intramedullary nailing of a tibial shaft fracture: a prospective 5-year follow-up cohort study","volume":"141","author":"Larsen","year":"2021","journal-title":"Arch Orthop Trauma Surg."},{"issue":"2","key":"bib19-20250116","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1016\/j.injury.2018.11.025","article-title":"Measuring outcomes following tibial fracture","volume":"50","author":"Morris","year":"2019","journal-title":"Injury."},{"issue":"3","key":"bib20-20250116","first-page":"629","article-title":"Development of the radiographic union score for tibial fractures for the assessment of tibial fracture healing after intramedullary fixation score for tibial fractures for the assessment of tibial fracture healing after intramedullary fixation","volume":"68","author":"Whelan","year":"2010","journal-title":"J Trauma."},{"issue":"1","key":"bib21-20250116","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.otsr.2019.10.010","article-title":"Application of the Radiographic Union Scale for Tibial fractures (RUST): assessment of healing rate and time of tibial fractures managed with intramedullary nailing Scale for Tibial fractures (RUST): assessment of healing rate and time of tibial fractures managed with intramedullary nailing","volume":"106","author":"Leow","year":"2020","journal-title":"Orthopaedics Traumatol Surg Res."},{"key":"bib22-20250116","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1097\/00003086-198309000-00003","article-title":"Classification of tibial shaft fractures and correlation with results after rigid internal fixation results after rigid internal fixation","volume":"178","author":"Johner","year":"1983","journal-title":"Clin Orthopaedics Relat Res."},{"issue":"2","key":"bib23-20250116","doi-asserted-by":"crossref","first-page":"86","DOI":"10.3390\/osteology1020009","article-title":"Normative values for femoral length, tibial length, and the femorotibial ratio in adults using standing full-length radiography femorotibial ratio in adults using standing full-length radiography","volume":"1","author":"Aitken","year":"2021","journal-title":"Osteology."}],"container-title":["JBJS Case Connector"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.24.00379","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:44:34Z","timestamp":1787751874000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.24.00379"}},"subtitle":["A Case Report"],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":21,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.cc.24.00379","relation":{},"ISSN":["2160-3251"],"issn-type":[{"value":"2160-3251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]}}}