Comparison between Clinico-radiological outcomes of primary closed static and dynamic interlocking nailing in transverse or short oblique diaphyseal fractures of tibia: A prospective study

Abstract

Introduction and Background: The objective of the study is to evaluate the comparative efficacy in terms of clinico-radiological outcomes in primary static versus primary dynamic intramedullary interlocking nailing of tibia. The principle of fixation for a tibial middle third fracture is to stabilize at the proximal metaphyseal region, the isthmus and the distal metaphyseal region. This 3 point fixation provides adequate resistance to the deforming axial and torsional forces at the fracture site. Two types of Locking techniques exist for the intramedullary nailing, Static and Dynamic. Materials and Method: A total of 17 patients of either sex who presented with closed trauma of transverse or short oblique diaphyseal fractures of tibia, which were observed between the years 2015-2017. Randomly, static and dynamic locking was done to the equal populations presented. The aims of the study conducted were to analyze time to union, functional recovery and incidence of complications. Johner and Wruh’s Criteria was used to analyze the functional outcome. All patients were followed for a period of 18months. Results: Upon evaluation with regard to Johner and Wruh’s criteria showed Excellent results in 9 out of 17 subjects, Good results in 7 out of 17 subjects and a Fair result in 1 patient. The average time of fracture union in case of dynamically and statically interlocked nailed tibiae is 13.00 and 15.22 weeks respectively. Therefore, the difference was 2.22 weeks. In our study, the results of tibia nailing was found to be in consonance with the earlier studies. Conclusion: We conclude that Primary Dynamic locking is a better option as compared to primary static locking in simple transverse or short oblique diaphyseal fractures of tibia as it leads to faster fracture healing and early return to function.