A Study on Role of Interlock Nailing in the Management of Tibial Diaphyseal Fractures

Abstract

Tibial fractures are one of the commonest orthopedic injuries. Tibial fractures are one of the commonest orthopedic injuries. In the past several years there has been a trend towards by use of small diameter nails without remaining in the management of unstable tibial shaft fractures. However it is important to remember that many closed fractures with less severe soft tissue injury, Treatment with an intramedullary nail with reaming allows placement of larger implant, thereby minimizing the incidence of mechanical failure. While maintain high rates of union. METHODS: In our study, 100 cases of tibial diaphyseal fractures were treated with Interlocking nailing in between May-2012 to April 2015 at Siddhartha Medical College/Government General Hospital, Vijayawada. RESULTS: In our study, among 100 cases 86 were closed fractures, and 8 were open fractures and 6 non-unions. Of the 100 cases 56 (56%) on right side, 38 (38%) on left side, 6 cases (6%) were bilateral. The commonest type of fracture is spiral or long oblique in 40 cases (40%). Transverse or short oblique in 28 cases (28%), comminuted in 24 cases (24%) and segmental in 8 cases (8%). The average time for union is 14 weeks with a range of 12-40 weeks. . 2 patients developed delayed union due to distraction at the fracture site. KEYWORDS: Interlocking nailing tibia, fracture tibia shaft. INTRODUCTION:Tibial fractures are one of the commonest orthopedic injuries. By its very location it is frequently exposed to injuries. These fractures continue to pose vexing problems for orthopedic surgeons, because of their common occurrence and morbidity. One of the problems among them is selecting the optimal method of treatment. They can't be managed by simple set of rules. According to Nicoll 1 tibial shaft fractures are important for two reasons. Firstly they are common, secondly their management is controversial. The incidence of tibial fracture is 9 times more than femoral fractures. Modern treat ment of tibial fractures include both operative and non-operative management, which allow near normal functional restoration of the extremity.It is incumbent on the orthopedic surgeon to be skilled in a variety of treatment methods including, closed functional cast bracing, external skeletal fixation, open reduction and internal fixation using indirect reduction techniques, intramedullary nailing. Because the spectrum of injuries to the tibia is so great that usually no single method is applicable to all fractures. With recent advances in metallurgy (Cold curing, variety of metals) and design of the nails such as prebent nails, prefabricated holes in nails, which lock fragments with screws have made trauma surgeon more confident in a dealing with these fractures. At present interlock nailing seems to be ideal method of treatment of tibial diaphyseal fractures. Sarmiento and co-workers, 2 documented their experiences with functional bracing in the successful management of closed tibial fracture. However, not all tibial fractures are amenable to brace treatment. It ...