COMPARATIVE STUDY ABOUT THE OUTCOME OF COMMINUTED FRACTURE SHAFT TIBIA FIXED WITH INTERLOCKING NAIL AND BIOLOGICAL PLATING

Abstract

Incidence of tibial diaphyseal fractures (26 per 100,000 persons per year in an average population) is the highest among long bone fractures. Now-a-days closed reduction with intramedullary interlocking nailing is generally accepted by surgeons to be the most popular method for fixation of tibial fractures in adults. To compare the outcome of fixation of comminuted tibial fractures following minimally invasive plating and nailing. It is prospective study of adult patients admitted to orthopedic department of Sohag university hospitals suffering from comminuted fracture Shaft tibia. The study will be approved by Scientific and Ethical committees at Sohag Faculty of Medicine. An informed written consent will be obtained from all participants. This study is being done on 30 patients of comminuted fracture shaft tibia. The average follow up time was thirty- three weeks (range from 19 to 54 weeks). The average time of union in all our 30 patients was about 13 weeks (range from 8 to 16 weeks). Three of the thirty patients had post operative fracture angulation was less than 5 degrees in the coronal and sagittal planes and one patient had post operative valgus angulation of about 5 degrees. As regard intraoperative exposure to radiation it was less in cases of biological plating There was two patients infected and they required removal of the nail and plates and treated by external fixation they represent about 10% of patients. Out of the 30 fractures managed by this method 24 fractures showed uncomplicated healing within a reasonable period of time. The complication rate was considered minimal. Only one case of non-union, two cases of delayed infection and 4 patients of malunion in valgus or varus malalignment, however we passed through a learning curve during performing this study, with most of the complications occurring in the early cases. So MIPO could attain satisfactory results in uncomminuted tibia shaft fractures, and locked intramedullary nailing is more appropriate in comminuted fractures.