Retrospective study of management of diaphyseal fractures of tibia with intramedullary interlocking nail

Abstract

Most common long-bone fracture is tibial shaft fracture encountered by most of the orthopaedic surgeons. Intramedullary nailing has become the treatment of choice for displaced diaphyseal fractures of the tibia in adults. There have been multiple reports to support the superiority of intramedullary nailing to other methods of treatment with respect to return to weight bearing and work. The aim of the study is to assess diaphyseal fractures of tibia with special reference to fracture anatomy, pattern and stability, to determine fracture healing and the union rates with intra-medullary interlocking nail and to study the functional outcome of intra-medullary interlocking nail. This is a retrospective cross sectional study. The present study includes 255 fractures of isolated tibia shaft surgically treated with closed intramedullary interlocking nailing during period from July 2010 to July 2016. All the patients who satisfied inclusion criteria were included in this study. Open tibia fractures were classified according to modified Gustillo and Anderson’s Classification. All enrolled patients evaluated with Johner & Wruh’s criteria. Functional outcome were graded into excellent, good, fair and poor and were statically analyzed. Final assessment was done at 6 weeks, 3months, 6 months and 12 months. In our present series, 168 out 240 patients had excellent results which correspond to around 70%, 48 patients had good results around 20%, 16 patient had fair results around 7%, and 8 patients had poor results around 3%. Closed intramedullary interlocking nailing is effective mode of treatment in tibial diaphyseal fractures. Immediate post-operative partial weight bearing and subsequent full weight bearing helps in fracture union. Open injuries with severe soft tissue injury further leading to postoperative infection was the main cause for nonunion, after inter locking nailing.