The Tibial shaft fracture are most common seen in road traffic accidents, Degree of displacement of fractures, degree of comminution, signs of infection and severity of soft tissue injury are the most important prognosis factors. Nail is a load sharing device with stiffness in both torsional and axial forces. Least damage to soft tissues is done by closed interlocking nailing.
Aim: To evaluate the functional and radiological outcome of Compound Tibia shaft fracture treated with primary interlocking nail.
Method: The present study was conducted in the department of Orthopaedics of SRMS-IMS, Bareilly from 2017-2020 on 20 patients, Extra articular Open tibia fractures with/without fibula fracture, Age above 18 years, Grade I, II & IIIA (Gustilo Anderson’s classification). Exclusion criteria: Open Tibial fracture treated primarily with external fixation, Non union of tibial fractures, Intra-articular fractures, Closed tibial fractures, Grade IIIB & IIIC fractures (Gustilo Anderson’s classification). standard surgical procedure of intramedullary interlock nailing of tibia was done. regular follow up was done with clinical and radiological assessment and final results made using Modified Ketenjian and Shelton Criteria.
Result: 85% of the cases were male, with 55% grade 1, 40% grade 2 and 5% grade 3A. 60% cases were due to RTA. 55% of cases had middle third fracture tibia,70% of cases were operated within 48 hours, the mean union time was 20 weeks by then full weight bearing walker walking was started. 20% of patient showed superficial infection which got resolved by regular dressing, with 1 case of delayed union and 2 cases of stiffness. at the end of 6 months 70% showed excellent, 25% good and 5% satisfactory results.
Conclusion: The fractures in our study united in an average of about 20 weeks. This one time procedure of Interlocked intramedullary nailing done which lead to union in almost all the cases. This procedure allows earlier fracture union hence early weight-bearing. Because of the high union rate and low infection rate, we consider closed interlocking nailing as the best mode of treatment for compound diaphyseal tibial fractures upto Gustilo-Anderson grade 3A.