Analysis of extra articular proximal third tibial fractures treated with interlocked intramedullary nailing (original) (raw)
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This study aims in evaluating the functional and radiological outcome following intramedullary interlocking nailing (IMIL) in closed lower third tibialfracture.This prospective and retrospective study includes 15 patients of lower third tibial fractures with a mean age of 28.5years , which have been treated by intramedullary interlocking nailing during the period 2010-2016.stable fixation was achieved in 15 patients. at the final follow up , the patients were evaluated functionally and radiologically based on JOHNER AND WRUH'S CRITERIA. The clinical results were excellent-8, good-5, fair-2 with average healing time of 28 weeks the outcome was satisfactory in all cases and comparable with other larger series. Using intramedullary nailing resulted in good fracture reduction without complications
Intra-medullary interlocking nail in extra-articular distal third tibia fractures
International Journal of Orthopaedics Sciences, 2020
Background: This study was performed to evaluate the results of intramedullary nailing of extraarticular distal tibial fractures. Methods: 24 tibial fractures that involved the distal 3rd of the tibia which were treated with reamed intramedullary nailing using either two or three distal interlocking screws. Obtained Radiographs were examined to determine the immediate and final alignments and fracture healing. Results: The average time to union was 15.6 weeks. Conclusions: Intramedullary nailing is found to be an effective alternative for the treatment of distal metaphysealtibial fractures.
Problems, Tricks, and Pearls in Intramedullary Nailing of Proximal Third Tibial Fractures
Journal of Orthopaedic Trauma, 2013
Proximal third tibial shaft fractures have been notoriously difficult to treat. Early reports resulting in high rates of malunion and fixation failure trended surgeons to move away from intramedullary nailing as definitive treatment. However, with the advent of a deepened understanding of the surround anatomy, several techniques have been developed to help maintain proper alignment without early failure or malunion. This review provides a concise update on the tips, tricks, and pearls available in achieving a stable well-aligned construct when definitively treating proximal third tibial shaft fractures via intramedullary nail.
International Journal of Orthopaedics
BACKGROUND: On the basis of the fracture location in the bone distal tibia fractures have the second highest incidence of all tibia fractures after the mid-shaft fracture of tibia. We conducted this study comparing functional outcome of intramedullary interlocking nail and locking plate fixation in the surgical management of extraarticular distal tibia fracture. We Assessed patients with Functional recovery between two treatment modality intramedullary interlocking nail and locking plate fixation in the surgical management of extraarticular distal tibia fracture. MATERIAL AND METHOD: Total of 42 subjects were consecutively recruited for the study. The Patients with Distal tibia fracture who came to our hospital Grouped into Group I and Group II. Group I (n = 21) patients were treated with Intramedullary interlocking nail; Group II (n = 21) patients were treated with open reduction and internal fixation with Plating. Clinical followup examination was performed at 4 weeks, 6 weeks, 10 weeks, 3 months, 6 months and 1 year. All patients were assessed clinically and radiographically. Assessment of the patient with Functional recovery was done with American orthopaedic foot and ankle score (AOFAS) minimum 6 months after injury. RESULT: The functional outcome was assessed by American ankle and foot score (AOFAS). In our study, 12 (57.14%) patients had excellent, 6 (28.58%) patients had good, 2 (9.52%) had fair and 1 (4.76%) patients had poor functional outcome from Group I. In group II, 11 (52.38%) patients had excellent, 8 (38.1%) patients had good and 2 (9.52%) patients had fair outcome. The comparison of the various parameters of this study with other published data shows that the results were comparable. CONCLUSION: Based upon the findings of the present study, both the methods studied are suitable treatments in the surgical management of extra-articular distal tibia fracture. IM nailing shows lower rate of delayed wound healing and superficial infection but more likely to require additional surgeries to achieve union, and probably will have more complaints of pain in their limbs or knee. While plating avoids malunion and knee pain but the functional and efficacy outcomes appear to be similar between the two treatment groups. Therefore, the choice of surgical procedure should be based on the surgeon's expertise, the clinical circumstances, and especially the patient's injury pattern.
International Journal of Orthopaedics, 2016
Patients and Method Thirty patients with proximal tibial fractures were treated and followed between June 2010 and February 2014 (44 months) with average 19 months. There were 23 males and 7 females. Age ranged between 23 to 55 years (mean, 38years) years. In 17 cases (56.7%) fracture was due to road traffic accident, 11cases (36.6%) due to work related injuries, and in 2cases (6.7%) due to sport injuries. Seven cases were open (4were Grade (I) and 3 were Grade (II) according to Gustilo-Anderson classification [3]. According to the A.O. Classification: 13 cases were Type A 2.1 (medial oblique), 9 cases were Type A 2.1 (II) (lateral oblique), and 8 cases were Type A 3.2 (fragmented wedge) (Figure 1).
Journal of Evidence Based Medicine and Healthcare, 2015
Whether to ream the compound tibia fractures witle intramedullary interlocking nailing or not has been an eternal debate. So we have conducted a study to compare the functional outcomes, rate of infection and time needed for union in reamed and unreamed interlocking nailing on open tibia fractures. METHODOLOGY: This study was carried out as a prospective, comparative study. 100 patients with open fractures of tibial shaft admitted in our hospital between June 2011 and January 2013 were enrolled in the study. Patients outside the age group of 20-50years of age, severely ommuniated fractures and fractures classified under Gustilo Anderson type IIIb and IIIc were excluded. 100 fractures were divided into two groups (reamed nailing and unreamed nailing) n=50 in each with simple randomization technique. Evaluation in the form of radiological union was done with serial x-rays and functional grading according to Klemm & Borner's criteria for tibial shaft fractures was done at the end of 6 months. RESULTS: Average fracture healing time was 16-20 weeks in both in undreamed nailing radiologically. Also, differences in rates of clinical union, clinical outcome, time for weight bearing and complication in both groups were not significant. Post-operative infection was found in 5 cases in reamed group and 3 cases in unreamed group. CONCLUSION: There are no clear indications or contraindications or advantage/disadvantage to favour either reamed or unreamed nailing over each other. Fracture union, functional outcome and rate of complications are similar in both groups. KEYWORDS: Reamed versus unreamed intramedullary interlocking nailing; fractures of shaft of tibia.
International Journal of Orthopaedics
are placed at first followed by distal interlocking screw. Mechanism of injury, age, sex, union time, foot function index, secondary procedure, complications, deformities are analyzed in the study. RESULTS: All patients were retrospectively analyzed. We could not find any significant relation between post operative malalignment and better foot function index (p = 0.975). Early union may not improve overall foot function index (p = 0.202). Automobile accident is the commonest mode of injury (48.5%) followed by automobile pediastrian (39.4%). Postoperative malalignment consist of cornal (3%), saggital (3%) and shortening (3%). Infection is one of the commonest complication found in our study (6.1%).
Interlocking Intra-medullary Nailing For Distal Metaphyseal Tibia Fractures
2016
Introduction: Tibia is one of the most common bones to sustain injury and fracture. The blood supply to distal part of tibia is precarious due to its subcutaneous nature. Thus complications like non union, delayed union and infections are very common in these fractures and thus management of these fractures is very controversial. The aim of this study was to evaluate the outcome of interlocking intramedullary nailing in the treatment of extra-articular distal tibial fractures. Materials & Method: 31 patients with mean of age 41 years with extra-articular distal tibia fractures both closed and compound were treated with simple tibia interlocking nail or tip locking tibia interlocking nail. Clinical diagnosis included AO/OTA type A1, A2 and A3 fractures, and Grade I, II and IIIA open tibial fractures by Gustilo and Anderson classification. Patients were assessed clinically and radiographically with Klemm and Borner classification with mean follow up period of 8 months and results grad...
2020
Introduction: Treatment of open tibia fracture is controversial. Complication like infection, re-operation, and nonunion are more common after these fractures. While grade II and III fractures are mostly treated with detriment and external fixator, grade I fractures are a matter of controversy. It is essential to evaluate factors affecting deep infections and fracture healing of closed and grade I open fracture of the tibial shaft treated with immediate or delayed interlocking intramedullary nail, and to study the functional outcome of the surgical procedure in a set up of a tertiary health care centre.
International Journal of Orthopaedics Sciences, 2020
Introduction: Distal tibial fractures are common long bone fractures that occur mainly due to a high velocity trauma. These are difficult to treat because of its subcutaneous location and poor blood supply. Many studies have been published on modalities of treatment of distal tibia fractures. Available options are Intramedullary nails, locking plates and external fixators. The aim of our study was to compare intramedullary interlocking (IMIL) nailing and locking plate (LP) for the treatment of these fractures. Materials and methods: This is a prospective study consisting data of 20 patients with distal tibial fractures operated for IMIL nailing and LP. Patients were followed up for radiological and clinical outcome using The American Orthopaedic Foot and Ankle Society (AOFAS) score. Results: The functional outcome was assessed by AOFAS score. Overall 10 patients obtained an excellent result (50%) and 8 obtained a good result (40%) and 2 obtained fair result (10%). IMIL nailing shows lower rate of delayed wound healing and superficial infection and plating may avoid malunion and knee pain. Discussion: The study suggests superiority of IMIL nailing over LP in terms of less rates of infections, early rate of union, early weight bearing. Whereas LP is better in anatomical and fixed reductions of the fracture and less knee pain. Hence the modality of treatment should be based on the patient's injury pattern, surgeon's expertise and clinical condition.