A study on complications of expert tibial intramedullary nailing of tibial fractures

Abstract

The mechanical behaviour of IM nails depends on both material and geometry of the design. Intramedullary nails, such as Lottes and Ender nails, used without reaming, have been employed successfully in the treatment of open tibial fractures and have been associated with low rates of post-operative infection. They are, however, contraindicated for comminuted fractures, as there tends to be shortening or displacement of such fractures around these small nails. Twenty five patients with proximal 1/3rd and distal 1/3rd tibia fractures were selected for the study. In total number of 25 patients admitted, there were 17 males (68%) and 8 females (32%). There were 20 closed fractures (80%) and 5 open fracture (20%) (GA type I-3, GA type II-2). The average range of motion in the knee joint was 135.6 degree, full ankle motion was observed in 20 patients. One patient showed a loss of >250 of motion at ankle compared to the normal side while 4 patients showed < 250 of loss of joint motion. One case (4%) of deep infection and implant failure was noted in the present study. Two patients (8%) showed a superficial soft tissue infection. One case (4%) of malunion was found with an anteroposterior angulation of 10 degrees, one case (4%) with a distal 3rd showed a shortening of < 1cm.No cases of significant rotational deformities and varus or valgus angulation deformities was noted.