International Journal of Orthopaedics Sciences
2016, Volume 2 Issue 3
Outcome of regular nailing in fracture of proximal third tibial shaft
Author(s): Khayas Omer K, Arun K and Ravikumar V
Abstract: Proximal third extraarticular shaft of tibia fractures treated by open reduction and internal fixation (ORIF) with anatomical plates are reported to have soft tissue problems often. Plating by Minimally invasive percutaneous plate osteosynthesis technique (MIPPO) is often preferred instead. Load sharing nails are an equally good option considering the extremely soft tissue friendly characters and possibility of early weight bearing. But a major problem of malalignment has to be addressed. Common deformity seen are apex anterior and valgus deformity. But these can be tackled by certain modifications from the routine nailing techniques like better xray guided nail entry point, nailing in semi extended position, parapatellar approach and manoeuvres for attaining and holding reduction. The clinical outcome of reamed intramedullary standard interlocking nailing of closed proximal third tibia fractures in 34 patients using the above mentioned guidelines was studied using Johner and Wruh’s criteria for outcome after a short term follow up of around 8 months. Majority of our patients belonged to a poor socioeconomic background and so expensive nails designed for proximal tibia fractures were not used. Instead our objective was to assess outcome using regularly used standard nails. More than 60 % cases had excellent outcome and > 20% had good outcome. 32 of the 34 cases had acceptable fracture union with no major complications. 2 cases had unacceptable malunion due to postoperative loss of reduction. Standard interlocking nailing when properly performed stands as an equally good cheap yet effective alternative for treatment of proximal third tibia fractures.
How to cite this article:
Khayas Omer K, Arun K, Ravikumar V. Outcome of regular nailing in fracture of proximal third tibial shaft. Int J Orthop Sci 2016;2(3):142-148.