A study of functional outcome of extra-articular displaced upper 3rd tibia fracture fixation with tibia interlocking nail with use of poller screw

Abstract

Background: The tibia is the second longest bone of the body, located at medial side of the leg. Among all the fractures in the body, tibia is the single largest bone that is commonly involved in injuries. Owing to the increase in vehicular accidents and industrial mishaps, high velocity trauma produces tibial fractures in increasing numbers. By its location and by being subcutaneous in most of its length tibia fractures tend to be open very commonly. Due to its precarious blood supply and scanty soft tissue coverage orthopedic surgeons around the world have been fighting infections and union problems. Extra-articular upper 3rd tibial fractures account for 5–11% of all tibial shaft fractures. This study was performed to analyze nailing with aid of poller screw for upper 3rd tibia extra-articular fractures.ObjectivesTo analyze the possible benefits of use of poller screw in upper 3rd tibia to prevent malalignment.To study the duration of union in proximal tibia fractures with the use nailing and poller screwTo establish the role of poller screw.To compare the results with published studies in term of hospital stay, mobilization, regaining normal range of movement and complications.Methods: This study was carried out at Department of orthopedics, tertiary care hospital from June 2021- October 2022, inclusive of both. During this period 30 patients were identified with upper 3rd tibia fractures. Functional outcome was assessed using Modified Karlstrom- Olerud score (clinical assessment) & RUST (radiographic union scale for tibial fractures) score.Results: 30 patient of upper 3rd tibia fracture were treated surgically with the use of Tibia Interlocking nail with use of Poller screw and the results were analysed functionally and radiologically. Conclusion: Acquiring and conserving acceptable alignment needs adopting the right entry point, establishing adequate reduction of the fracture whilst reaming and nail insertion, securing appropriate route of reamers, utilizing a poller screw, and picking of suitable supplemental fixation like a plate or external fixation.