Abstract: Aims & Objectives:
To evaluate outcomes of both techniques with regards to healing, union, complications, range of motion at knee and ankle joints in middle and distal third tibia fractures. Materials: 40 patients of either sex with closed and open fractures (upto Gustillo- Anderson type 3A) were included in this study. All patients were briefed about purpose of study, informed consent for surgery and for use of data for study were purpose were obtained. Patients with G.A. type 3B and above open fractures, proximal shaft fractures, fractures primarily treated with external fixator and intra-articular fractures were excluded from this study. Primary outcomes were assessed by a Knee Score and Ankle score system by Hughes et al
Results and Observations: Out of the 40 patients, there was an increased incidence of fracture in the 20-40 years age group (62.5%). 30(75%) patients showed union within 15 weeks of surgery, 10(25%) showed union within 15-20 weeks. Average union time for was 13.1 weeks with no significant difference between fracture union in open fractures(14.3 weeks) and closed fractures(13.7 weeks). The patients were evaluated with respect to range of motion, time to union, and complications. Functional results were assessed using the Johner-Wrush criteria.
Conclusion: Enders nailing shows satisfactory functional and radiological outcomes in the treatment of adult distal third of tibia fractures and can be an alternative in the treatment with regards to intramedullary nailing. Short operative time, minimal invasive techniques, dynamic controlled motion at fracture site leading to early callus formation which is favorable biomechanically and biologically and sufficient stability in all planes that allows early motion without additional fracture support with usage in segmental fractures, poor skin condition, osteoporotic bones lends credence to Enders nailing being a viable treatment option for distal third of tibia fractures.