Tibia is the most commonly fractured long bone in the body. The use of non-operative treatment of tibial fractures that are widely displaced or that are the result of high-energy forces is associated with a high prevalence of mal-union, stiffness of the joint, and poor functional outcome. Closed Tibial diaphyseal fractures have been internally fixed with Plates or with Intramedullary fixation devices like centromedullary nails (K-nails, V-nails), Interlocking intramedullary nails (Reamed or Unreamed). Interlock nailing has proven to be the method of choice with advantages of early stabilization, early mobilization, with high union rates, less infection rate and implant failure.
Objectives: Aim of the current research was to study diaphyseal fractures and to assess functional outcome of patients with tibial shaft fracture treated with intramedullary interlocking tibial nail.
Materials and Methods: A prospective study of 50 patients presenting with tibial diaphyseal fracture at Tertiary Care Hospital were admitted and evaluated from May 2011 to July 2013. Patients fulfilling our inclusion criteria and were included in the study and treated with intramedullary interlocking tibial nail. An Alho and Ekeland1 criterion was used to assess the functional outcome.
Results: The results of interlocking nail for fracture diaphyseal tibia were excellent in 40 patients (80%), good in 7 patients (14%) fair in 2 patients (4%) and poor in 1 patient (2%). The average healing time was 23.48 weeks. In our study valgus/valgus angulation deformity of <50 were noted in 3 patients and in one patient anterior/posterior angulation was noted less than 50. There was 1 superficial infection (2%), 8 patients had delayed union (16%), 4 patients had mal-union (8%), 1 patient had non-union (2%) and 1 patient had shortening of <2 cm due to comminuted fracture (2%).
Conclusions: Fracture diaphyseal tibia is seen in high velocity injury like road traffic accident and it commonly affects younger population. Tibial intramedullary interlocking nailing has advantages as it preserves periosteal blood supply, maintains length, rotation, alignment, lowers the infection and mal-union. Closed internal fixation with intramedullary interlocking tibial nail is a standard surgical procedure for management of tibial diaphyseal fractures. The advantage of rapid rehabilitation and relatively few complications serve to recommend it for wider use.