Comparative study of functional outcome of primary closed intramedullary nailing in compound vs closed tibial diaphyseal fractures

Abstract

Background: Open fractures of the tibia usually indicate a high-energy injury to soft tissue and bone with resultant difficulties of infection and poor bone healing. Material & Methods: 20 cases of open and closed tibia diaphyseal fractures were followed for period of one year from July 2019 to June 2020 at Department of Orthopaedics, Rajah Muthiah Medical College, Annamalai University. Result: The Mean time of union was 14 weeks 4 days for compound fractures overall, for grade I cases – 13 weeks 3 days, for grade II cases – 15 weeks, and for grade IIIA cases – 17 weeks 1 day, for closed cases – 12 weeks 2 days. Based on Johner-Wruhs criteria 90% and 10 % of grade I cases had excellent and good outcome. 80% and 20 % of grade II cases had excellent and good outcome. 75% and 25% of grade IIIA patient had excellent and good outcome, 90% and 10% of closed cases had excellent and good outcome respectively. Complications encountered was 2 patients in open fracture group had anterior knee pain, 1 patient (5%) had superficial infection, 1 patient went for non-union, and 1 patient had screw breakage.Conclusion: This study demonstrates that grade 1, 2 and 3A open tibial shaft fractures can be treated with primary debridement and interlocking nail when compared with closed tibial diaphyseal fracture, There was no statistically significant difference (pvalue:0.492) in union rate, infection rate (5%) and functional outcome (p value 0.018) between the two groups.