Abstract
Tibia is the commonest bone to sustain open injury because of subcutaneous position. Treatment of open fractures requires simultaneous management of both skeletal and soft tissue injury. Intramedullary nailing with reaming is generally considered to be contraindicated for open fractures tibia, because it damages the endosteal blood supply which will lead to non-union, deep infection. However, recent studies with or without reaming in open fracture tibia shows no influence in healing of fracture. Purpose: To compare the clinical and radiological results of intramedullary interlocking nailing of open fractures of the tibial shaft after reaming versus unreamed medullary canal. The aim and objective is a comparative study on the technique, outcome and time taken for clinical and radiological union in either of the reamed or unreamed interlocking nailing in tibial shaft fractures. The operative technique, advantages and disadvantages, follow up, time taken for bony and radiological union and complications if any and overall functional outcome will be evaluated in patients. The follow up of patients will be done in the immediate post operative period and subsequently at periodic intervals both clinically and radiologically and the result so obtained will be compared.
Highlights
The overarching goal of crop farming is high yields
Considering the higher values of these two nutrients in Dome treated soils compared to Flexi, Dome bioslurry may contribute to a faster build-up of soil organic matter
Many farms in sub-Saharan Africa suffer high pH levels, which can be amended by continuous use of bioslurry as it was seen to raise the soil pH
Summary
The overarching goal of crop farming is high yields This has been on the decline, contributed by nutrient mining due to continuous cropping, soil erosion, lack of or insufficient use of organic and inorganic fertilizers [1]. Use of inorganic fertilizers has been the norm in increasing crop yields [4] Their excessive and long term use can affect the soil physical, chemical and biological properties [5,6], reducing soil productivity. Not all farmers can access the required amounts Crops require both macro and micronutrients for proper growth, but no single inorganic fertilizer contains all of the required nutrients. According to Signor and Cerri [7], application of N-fertilizer is the greatest contributor to N2O, underscoring the relevance of embracing measures to reduce its emission into the atmosphere
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