A Study on Internal Fixation of Compound Fractures of Tibia Using Interlocking Nail Without Reaming

Abstract

As one-third of the tibial surface is subcutaneous throughout its length, open fractures are commonly encountered in this bone. The factors which determine the outcome of these fractures are severity of the injury, indicated by the degree of initial displacement, comminution and soft tissue injury and the damage to the tibial blood supply. In open fractures not only is the endosteal circulation disrupted but also the periosteal circulation, because of periosteal stripping. The various available options of treatment such as conservative short leg or long leg casting, open reduction and internal fixation with plates and screws, intramedullary fixation (Including Ender pins, Intramedullary nails and Interlocking Intramedullary nails with reaming or without reaming) and external fixation techniques have their own advantages and disadvantages. The present study was conducted in the Department of Orthopaedics, Gandhi Hospital, during the period from October 2013 to November 2015, to evaluate the results of internal fixation with interlocking intramedullary nailing without reaming in the treatment of the open fractures of tibia. In our study, we got 91% good-to-excellent results evaluated by Johner and Wruh criteria. We opine that closed unreamed interlocking intramedullary nailing yields good-to-excellent results in compound diaphyseal fractures of the tibia, as this technique allows a good control over the rotations with axial stability of the fracture, thus maintaining the length of the limb and enabling early joint motion. The endosteal blood supply is also well preserved. These factors help in lowering the rates of infection, malunions and non-unions.

A comparative study of functional and radiological outcome in the management of distal tibia fractures treated by intra medullary nailing and minimally invasive locking plate

“…Because the tibia is the largest bone in the body and one of the principal load-bearing bones in the lower extremity, fractures can cause long-term morbidity and disability if not adequately treated. Infection and nonunion are more frequent since it is a subcutaneous bone [4] . Distal tibia fractures remain one of the most difficult to treat [5,6] due to the high risk of complications.…”