Efficacy of modified Judet's technique in non union tibia, with inter locking nail as fixation device

Abstract

Background-Non Union Tibia can be managed by many techniques, Judet's osteoperosteal flap is one of them. In traditional Judet's Technique compression plate was used as fixation device. We use interlocking nail as fixation device and studied the efficacy of its usage. Objective: To evaluate efficacy of modified Judet's technique. Methodology: A total 20 Patients of Victoria Hospital and Bowring & Lady Curzon hospital Bangalore during the period from 2017 to 2019 with aseptic non-union tibial fractures are taken for study. All cases were treated with opening of fracture site, freshening of fracture edges and raising of osteoperosteal flap followed by internal fixation with interlocking nail. The cases were followed for post operatively at 4 weeks, 12 weeks and 24 weeks. Result: Excellent results were obtained in 80% of cases. Good results were obtained in 15%, fair results in 5%. Complications include 10% delayed wound healing, 10% restriction of ankle and knee movements. Conclusion:Our study suggests that Judet's osteoperiosteal decortication (Shingling) with interlocking nail as internal fixation device is an effective technique in the surgical management of aseptic non-union tibia. It is also cost effective and alternative to other bone healing augmentation procedures. The procedure is simple and easily reproducible in most hospital settings, even in peripheral centres.

Functional and Radiological Outcome Analysis of Osteoperiosteal Decortication Flap in Nonunion of Tibia

“…e disparity in results among the three groups underlines the need of categorizing nonunions based on their severity or complexity before prognosticating the case and estimating the likelihood of union. Guyver et al [11] observed a 92% union rate in their study, while Raju et al [28] showed a 100% union rate in their case series of 20 patients with tibial fracture nonunion. In both these studies, the classification of nonunion according to their severity or complexity has not been taken into consideration.…”