Abstract: Purpose: To evaluate the clinical use of trans-medullary support screw (poller screw) as a supplement to stability in metaphyseal fractures of tibia treated with statically locked intramedullary nail.
Material and Method: This was a prospective study of 20 cases of tibial metaphyseal fractures treated with statically locked intra medullary nailing with supplementary trans-medullary support screw between MAY2019 TO MARCH 2020. At PGI SWASTHIYOG PRATISTHAN, MIRAJ. All patients were followed up for atleast 6 months and serial radiographs were taken at 1 month 3 month and 6 months interval. Fractures included were proximal and distal 1/3rd tibia fracture of all age groups.
Result: All the relevant data were analysed. All the fractures eventually united in a mean period of 11.5 weeks (95% LCL 10.11weeks and 95% UCL 12.88 weeks). Karlstrom-Olerud score was excellent in 13 fractures (65%), good in 6 patients (25%) and fair in 2 patients (10%). The alignment was maintained till union with the mean remaining the same in the coronal plane. Conclusion: Trans-medullary support screw when supplemented the intramedullary nailing of metaphyseal fractures of tibia,
1. Were effective in achieving the fracture alignment, acting as a reduction tool
2. Improved the stability of the bone – implant construct, by functionally reducing the medullary width
3. Maintained the fracture alignment till union, preventing loss of initial reduction.
4. Maintaing 3 point fixation of the farcture if not maintained by tibia interlock nail.
