Functional Outcome of Internal Fixation of Fibula by Closed Tens Nailing in Addition to Tibia in Distal Both Bone Leg Fractures

Introduction: Treatment of adult tibiofibular fractures, especially severely comminuted fractures, is technically challenging dueto the lack of reduction markers and difficulty in restoring the alignment. Fixation of the fibula can facilitate the reduction of thetibia fracture and restoration of the lower extremity alignment.Aim: This study aims to study the functional outcome of internal fixation of fibula by closed tens nailing in addition to tibia indistal both bone leg fractures.Materials and Methods: Patients with distal both bone leg fractures for whom fibular fixation was done in addition to tibia nailing inGovernment Rajaji Hospital, Madurai from July 2016 to September 2018 with a minimum 1-year follow-up were included in the study.Results: In this study among 15 patients, 9 patients did not have any angulation, 6 patients had varus angulation with mean varusof 2°, and none of the patients had valgus angulation. The mean range of movements in patients with fibula fixation was 96%. Themean time of union in these patients was 5 months (minimum of 4 months and a maximum of 7 months). Johner and Wruch’s criteria:Among the 15 patients, 12 patients (80%) had excellent results and 3 (20%) had good results. There were no fair and poor results.Conclusion: Treatment of distal third both bone leg fractures by fixation of fibula by closed tens nailing in addition to the tibia isuseful in anatomical reduction of tibia and reduced malalignment of tibia with good ankle functions. Further randomized controlstudies are needed to assess the long-term functional outcome in these patients.

Functional Outcome of Comminuted Fracture Shaft of Humerus Operated by Minimally Invasive Anterior Plate Osteosynthesis – A Prospective Study

Introduction: Minimally invasive plate osteosynthesis (MIPO) has been advocated as a safe approach to humeral shaft fracturemanagement.Aim: This study aims to analyze and evaluate the functional outcome of surgical management of comminuted shaft of humerusby minimally invasive anterior plate osteosynthesis.Materials and Methods: In this prospective study, patients with humeral shaft fractures were included in the study. All thepatients with a comminuted diaphyseal fracture of humerus underwent MIPO technique. Constant–Murley score for shoulderand Mayo Elbow Performance Score (MEPS) for elbow were assessed postoperatively at 3 months, 6 months, and 2 yearsfollow-up and score calculated at each visit.Results: In 15 patients, the mean Constant score was 87 on the affected side and 90.67 on the unaffected side. The meanMEPS was 97.33 ranging from 85 to 100. The mean surgical time with MIPO was 69 min (range: 60–90 min). The averageblood loss with MIPO was 109 ml (range: 75–150 min).Conclusion: MIPO of the humerus gives good functional and cosmetic results and should be considered one of the managementoptions in the treatment of humeral diaphyseal fractures.