{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T20:48:36Z","timestamp":1773089316258,"version":"3.50.1"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:00:00Z","timestamp":1738627200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Tibial shaft fractures account for the majority of operatively treated long bone fractures and have the greatest prevalence of open wounds. For both open and closed injuries, intramedullary fixation has become the standard of therapy. At Addis Ababa Burn, Emergency, and Trauma (AaBET) Hospital, the rates of poor radiological outcomes for tibial shaft fractures treated with intramedullary fixation are unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective health facility-based cross-sectional study design was conducted among patients with tibial shaft fractures treated with intramedullary nails at AaBET Hospital. Data were collected by reviewing medical records and x-rays. The study was conducted on a sample size of 160 using a simple random sampling technique. Descriptive statistics such as frequency and percentage were used to summarize the results. Binary logistic regression was used to describe the associations between variables. A <jats:italic>P<\/jats:italic>-value\u2009&amp;lt;\u20090.05 was considered statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study included 122 (76.3%) men and 38 (23.8%) women with a mean age of 36.3\u2009\u00b1\u200913.9. The magnitude of poor radiological outcomes among the tibial shaft fracture patients treated with intramedullary nail fixation was 23.1%, with factors including include the presence of medical comorbidity [adjusted odd ratio (AOR) (95% confidence interval, CI): 16.5 (2.524\u2013108.69)], having diabetes mellitus [AOR (95% CI): 3.85 (1.07\u201314.08)], Gustilo\u2013Anderson type III (GA III) open fractures [AOR (95% CI): 17.4 (3.11\u201397.72)], and post-operative infection [AOR (95% CI): 13.9 (5.8\u201333.16)] identified as being significantly associated with poor radiological outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The magnitude of poor radiological outcomes in this study is comparable to other similar studies. The study found that factors including Gustilo\u2013Anderson type III open fractures, diabetes mellitus, and post-operative infections increase the odds of poor radiological outcomes in patients with tibial shaft fractures after intramedullary nailing. Therefore, surgeons should improve their assessment and evaluation of patients with infection signs and use negative wound pressure for GA III fractures.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2025.1473038","type":"journal-article","created":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T06:34:33Z","timestamp":1738650873000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Poor radiological outcomes and associated factors among tibial shaft fracture patients treated with intramedullary nail fixation at Addis Ababa Burn, Emergency and Trauma Hospital, Ethiopia"],"prefix":"10.3389","volume":"12","author":[{"given":"Yohannes","family":"Shugie","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Kebede","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fanna","family":"Adugna","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dereje Bayissa","family":"Demissie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tilahun","family":"Desta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,2,4]]},"reference":[{"key":"B1","volume-title":"Rockwood and Green\u2019s Fractures in Adults","author":"Heckman","year":"2014"},{"key":"B2","first-page":"203","article-title":"Outcome of intramedullary interlocking SIGN nail in tibial diaphyseal fracture","volume":"23","author":"Khan","year":"2013","journal-title":"J Col Physician Surgeon Pakistan"},{"key":"B3","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1159\/000092993","article-title":"Closed and open grade I and II tibial shaft fractures treated by reamed intramedullary nailing","volume":"15","author":"Djahangiri","year":"2006","journal-title":"Med Princ Pract"},{"key":"B4","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1016\/j.mporth.2016.10.002","article-title":"Open tibial fractures","volume":"31","author":"Fernandez","year":"2017","journal-title":"Orthop Trauma"},{"key":"B5","first-page":"9","article-title":"Intramedullary nailing for open fractures of the tibial shaft","volume":"23","author":"Malik","year":"2012","journal-title":"Medical Forum Monthly"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1355","DOI":"10.1007\/s00264-021-04973-y","article-title":"The history of intramedullary nailing","volume":"45","author":"Bekos","year":"2021","journal-title":"Int Orthop"},{"key":"B7","doi-asserted-by":"publisher","first-page":"2007","DOI":"10.1007\/s00264-012-1625-3","article-title":"Achieving locked intramedullary fixation of long bone fractures: technology for the developing world","volume":"36","author":"Phillips","year":"2012","journal-title":"Int Orthop"},{"key":"B8","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1097\/TA.0b013e3181a7c16d","article-title":"Development of the radiographic union score for tibial fractures for the assessment of tibial fracture healing after intramedullary fixation","volume":"68","author":"Whelan","year":"2010","journal-title":"J Trauma Acute Care Surg"},{"key":"B9","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1302\/2046-3758.54.2000628","article-title":"The radiographic union scale in tibial (RUST) fractures: reliability of the outcome measure at an independent centre","volume":"5","author":"Leow","year":"2016","journal-title":"Bone Joint Res"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1653","DOI":"10.1016\/j.injury.2014.06.025","article-title":"Health outcomes of delayed union and nonunion of femoral and tibial shaft fractures","volume":"45","author":"Tay","year":"2014","journal-title":"Injury"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1370","DOI":"10.1302\/0301-620X.96B10.32914","article-title":"Outcome at 12 to 22 years of 1502 tibial shaft fractures","volume":"96","author":"Connelly","year":"2014","journal-title":"Bone Joint J"},{"key":"B12","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1097\/00005131-200103000-00011","article-title":"One-year outcome after tibial shaft fractures: results of a prospective fracture registry","volume":"15","author":"Skoog","year":"2001","journal-title":"J Orthop Trauma"},{"key":"B13","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1097\/00013611-200212000-00011","article-title":"Failed fixation of the tibial shaft","volume":"17","author":"Lang","year":"2002","journal-title":"Tech Orthop"},{"key":"B14","doi-asserted-by":"publisher","first-page":"297","DOI":"10.22271\/ortho.2017.v3.i1e.47","article-title":"A study of management of tibial diaphyseal fractures with intramedullary interlocking nail: a study of 50 cases","volume":"3","author":"Rathwa","year":"2017","journal-title":"Int J Orthop Sci"},{"key":"B15","doi-asserted-by":"crossref","first-page":"795","DOI":"10.22271\/ortho.2017.v3.i3k.120","article-title":"Retrospective study of management of diaphyseal fractures of tibia with intramedullary interlocking nail","volume":"3","author":"Hariprasad","year":"2017","journal-title":"Int J Orthop Sci"},{"key":"B16","first-page":"83","article-title":"Functional and radiological outcomes with intramedullary interlocking nailing of tibial shaft fracture","volume":"7","author":"Kushwaha","year":"2022","journal-title":"J Nat Med Col"},{"key":"B17","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1590\/1413-785220182603184073","article-title":"Evaluation and comparison of open and closed tibia shaft fractures in a quaternary reference center","volume":"26","author":"de Lima Santos","year":"2018","journal-title":"Acta Ortop Bras"},{"key":"B18","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1016\/j.jcot.2017.08.006","article-title":"The diaphyseal aseptic tibial nonunions after failed previous treatment options managed with the reamed intramedullary locking nail","volume":"10","author":"Kostic","year":"2019","journal-title":"J Clin Orthop Trauma"},{"key":"B19","article-title":"JATNonunion [Updated 2021 A 6]","author":"Rodriguez-Buitrago","year":""},{"key":"B20","first-page":"88","article-title":"Radiological and clinical details of major adult limb fractures in a teaching hospital, AAU, Ethiopia","volume":"14","author":"Admasie","year":"2009","journal-title":"East Cent Afr J Surg"},{"key":"B21","doi-asserted-by":"publisher","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"},{"key":"B22","doi-asserted-by":"crossref","first-page":"334","DOI":"10.2106\/00004623-199703000-00003","article-title":"Locking intramedullary nailing with and without reaming for open fractures of the tibial shaft. A prospective randomized study","volume":"79","author":"Keating","year":"1997","journal-title":"J Bone Joint Sur A"},{"key":"B23","doi-asserted-by":"publisher","first-page":"32","DOI":"10.17159\/2309-8309\/2017\/v16n1a4","article-title":"Gunshot tibia fractures treated with intramedullary nailing: a single centre retrospective review","volume":"16","author":"Hilton","year":"2017","journal-title":"SA Orthop J"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.2147\/TCRM.S108790","article-title":"Is there a relationship between fracture healing and mean platelet volume?","volume":"12","author":"Serbest","year":"2016","journal-title":"Ther Clin Risk Manag"},{"key":"B25","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1302\/2633-1462.24.BJO-2021-0012.R1","article-title":"Risk factors associated with delayed and aseptic nonunion following tibial diaphyseal fractures managed with intramedullary nailing","volume":"2","author":"Makaram","year":"2021","journal-title":"Bone Jt Open"},{"key":"B26","doi-asserted-by":"publisher","first-page":"4278","DOI":"10.12659\/MSM.906293","article-title":"The irisin hormone profile and expression in human bone tissue in the bone healing process in patients","volume":"23","author":"Serbest","year":"2017","journal-title":"Med Sci Monit"},{"key":"B27","first-page":"972","article-title":"Review of history and changes in self care education to diabetic patients in the world, Iran and the nurses position in this field","volume":"10","author":"Shirazi","year":"2011","journal-title":"Iran J Health Educ"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1473038\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T06:34:37Z","timestamp":1738650877000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1473038\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,4]]},"references-count":27,"alternative-id":["10.3389\/fsurg.2025.1473038"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2025.1473038","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,4]]},"article-number":"1473038"}}