Diaphyseal tibial fractures; closed intramedullary interlocking nailing

ABSTRACT

To determine the outcome and consequences of close intramedullary interlocking nailing in diaphyseal tibial fractures and to observe the hospital stay and complications in this method of treatment. The study was conducted in department of orthopaedic unit-I at Liaquat University Hospital Jamshoro/Hyderabad during Jan 2011 to June 2012. The present study constituted on 43 patients, 3 cases were dropped during follow up and the rest 40 cases completed 1 year post operative follow up. After having routine laboratory investigations and necessary x - rays, the stable patients were operated for intramedullary interlocking nailing on routine operating days. The patients were assessed according to the criteria mentioned in follow up proforma from date and time of arrival to final visit in review clinic and results were tabulated. Among 40 patients, 38 [95%] were males and 02 [5%] females. The age ranges from 17 to 50 years with mean age of 32.23 years. There were 25 close fractures [62.5%] 15 open fractures [37.5%], among these 13 [32.5%] were Gustilo type I and 2 [5%] were of type II. The mode of injury in majority [75%] of cases was road traffic accident. Good union achieved in 39 cases [97.5%] in 17.53 weeks. But only 1 [2.5%] case unfortunately went in infected non union and was converted into Illizarove external Fixation. The main complication observed after surgery was loosening of screw in 3 [7.5%] cases. Deep infection was observed in the medullary cavity in 3[7.5%] cases [table-V]. It has been observed in analyzing the functional outcome of these patients that majority [80%] of cases was able to sit on bed in 12-24 hours and was able to stand in 24-48 hours. In next 24 hours after surgery 75% of patients were pain free. The mean hospital stay in these cases was 8.53 days and by the 48th week all of cases were able to join their job except one case in which non union observed due to infection. The data from the current study reveals that intramedullary interlocking nailing of closed and open grade I and II fractures is a safe technique. It combines a high rate of union with a low complication rate, less hospitalization and early return to job