Dynamically locked intramedullary interlocking nail for fracture shaft of tibia: An effective surgical protocol with minimal complications

Abstract

Introduction: Fracture shaft of tibia is one of the most common injuries presenting to a trauma center. Closed intramedullary interlocking nail is the gold standard surgical procedure. But even with advanced techniques there are several reports of delayed and nonunion of these fractures. We evaluated the results of dynamically locked tibia IMIL nail for fracture shaft of tibia. Materials and Methods: 90 patients with fracture shaft of tibia were included in the study between 2013 to 2015. AO type A1 and A2 were included in the study. Comminuted fractures, open injuries were excluded from the study. Outcomes were evaluated based on time to fracture union, limb alignment, walking ability and range of motion. Results: There was fracture union in 100% of the cases an average duration of 16 weeks. There were no cases of nonunion/delayed union, significant mal-alignment of the fracture. The mean range of motion score was 3.6 and the mean walking ability score was 3.8. Discussion: Non comminuted fracture shaft of tibia treated with dynamically locked IMIL nail gave good to excellent results in 87 of the 90 cases with respect to fracture union, limb alignment, range of motion and walking ability. There were no cases with implant failure or limb length discrepancy. It produces good fracture compression and early weight bearing adds to its advantage. Conclusion: Dynamically locked IMIL nail for non comminuted fracture shaft of tibia gives excellent clinical and radiological outcome. It also avoids any chances of delayed/nonunion of the fractures of tibial shaft. Keywords: Tibia, Shaft, Fracture, Dynamic, Locking, Nail.