Publication:

Role of tibia interlocking nail in treating distal tibial metadiaphyseal fractures: study of 46 cases

Background Distal tibial diaphyseal fractures are known for its various challenges that orthopaedicians face while treating. While performing surgery, many principles of fixations are needed to be properly addressed. This study was undertaken to know the efficiency of closed reduction, polar screws and tibia interlocking nail fixation at our Institute.

Methods The data, which were collected from the medical records and Department digitalised storage system and from the HMIS patient filing system, included age, sex, date of admission, type of admission (elective versus emergency), and AO classification of distal tibial fracture admitted in Orthopaedics Department from 2007 to 2013. Analyses of 46 cases, 34 males and 12 females, were made to find out the functional, radiological outcome, associated complications in treating distal tibia with ILN. During Analysis, association of the single event with the variables was estimated using Relative Risk, with a 95% confidence interval and P value of <0.05 was considered significant.

Results The average time to union of the closed fracture was 15.4 weeks (range: 12–28 weeks). The healing times for the primarily nailed compound Grade I averaged 17.8 weeks (range: 15-34 weeks). Complications of delayed union occurred in 3 cases, and two cases of non-union. Infection in 6 cases (5 superficial, 1 deep), screw breakage in 4 cases and 3 cases of significant malalignment. The final functional outcome of 33 patients had excellent results, 11 had good results and 2 had fair results as determined by criteria of Johner and Wruh.

Conclusions The dynamic osteosynthesis of distal tibia by interlocking nail and judicious use of poller screws is an effective alternative for the treatment of distal metaphyseal tibial fractures.