Background and Objectives: The indication for intramedullary nailing has expanded widely. Nail design improved since first introduction but distal locking is still difficult, even with the use of image intensifier. A jig is available only for proximal locking. The jigs designed for distal interlocking have not been successful and reliable. The objective of study is studying patterns in tibial fractures. Make distal locking easy and convenient. Reduce radiation exposure. Reduce operating time.
Methods: A study of 23 patients who had fracture of both bones leg was under taken in NRI medical college and general hospital from January 2010 and October 2011. After performing tibial nailing, 1st medio-lateral distal locking screw was done by free hand technique and second screw locked by the distal jig designed in our institute. The purpose of study is to compare radiation time and total duration of distal locking by free hand technique and distal locking by the jig. Categorical variables are compared using paired t test. P valve of <0.05 was considered to be significant.
Results: The average operating time for tibial nailing was 93 mins. Distal locking of first medio-lateral screw using free hand technique was 6.8 mins (3min-15min). Distal locking of second medio-lateral screw using distal jig was 3-5 mins (2min-5min). Average radiation exposure (shots) for first screw was 6.3 shots (3 to 16 shots).second screw is 3.6 shots (2 to 6 shots). P valve is 0.001.
Interpretation & Conclusion: Due to significant difference between the two methods in duration of distal locking and radiation exposure. Distal locking with the jig is advantages for closed intramedullary nailing of tibial fractures. Still high learning curve is present in distal locking.