Biyomekanik bakış açısıyla, intramedüller çivilemenin tibia diyafiz kırıklarının fiksasyonu üzerindeki etkinliğinin değerlendirilmesi

Abstract

Aim: The aim of the study was to exhibit the success rate of nailing on tibia shaft fractures. Biomechanical advantage of the nails was also evaluated and discussed in this study. Material and Methods: Reamed and static interlocking intramedullary nailing was performed with closed or mini-open reduction in 35 patients (25 males, 10 females; mean age 37.14±13.13 years). 27 fractures were closed and 8 fractures were open fractures. The evaluation in the study was performed according to Johner and Wrush criteria. Results: The mean follow-up period was 12.5 months (range 5 to 20 months). Union occurred in all patients. Mean union period was 17.02±7.96 weeks. In four cases, a valgus angulation of 2-5 degrees was detected that whom had distal third tibial fractures. In one case, an external rotation more than 10⁰ was detected and in another case, grave claudication was shown. In two cases, extremity shortening of 6-10 mm was seen. According to ankle and subtalar mobility; 27 (77.1%) of the patients were recorded as excellent, 7 (20%) good, 1 (2.9%) moderate results. According to Johner and Wrush criteria; 54.3% of the patients were recorded as excellent, 34.3% good, 8.6% moderate and 2.8% bad results. Conclusion: This study suggests that reamed interlocking intramedullary nailing is an effective method in tibia diaphyseal fractures because of successful functional results, high union and low complication rates. On the biomechanical side, anti-rotation of the fixation area and axial load sharing capacity of nailing has critical demand on fracture healing.