Functional outcome of distal third tibial fractures with intramedullary tibial locking nail and poller screws

Abstract

Back Ground and Objectives: Tibia is the most commonly fractured long bone in the body with an annual incidence of Tibial shaft Fractures is 2 per 1000 individuals. Tibia is a large bone of the body and one of the principle load bearing bone in the lower extremity; Tibial fractures can cause a long morbidity and extensive disability unless treatment is appropriate. Various techniques are now available for the treatment of tibial fractures where the orthopedic surgeon must be aware of the advantages, disadvantages and limitation of each procedure to select the right choice of treatment for each particular patient. In case of tibial fractures the type; location; degree of comminution; age and patient’s social and economic demand may influence the method of treatment. In distal tibia fractures; malunion and stiffness of joint are commonly encountered problems, due to which the use of non-operative treatment of widely displaced distal tibia fractures may result in poor functional outcome. Hence the present study was undertaken to provide satisfactory functional outcome and to know the advantage and complications of the Tibial Interlocking nail with polar screws. Materials and Methods: The present study was conducted in Department of Orthopaedics at Sri Siddhartha medical college, hospital and Research Center Tumkur during the period from August 2015 and July 2017. A total of 30 patients attending the hospital during the study period with closed distal third diaphyseal fracture of Tibia aged more than 18 years who were medically fit for surgery were included in the study. Results: In this study, the mean age of patients with this fractures was 37.2 years and maximum patients were in the age group of 31-40 years. Males predominated in our study. Road traffic accidents are the main cause of fractures followed by fall. In our series most of the cases were transverse fractures 13 patients (43.37%) followed by oblique fractures 9 patients (30%) and 8 patients with spiral fractures (26.7%). All the fractures taken into the account occurred at the distal tibial region. Results were excellent in 93.3% of the patients, good in 6.67% with no fair and no poor cases as graded according to Klemm and Bornner criteria. Conclusion: The method has a long learning curve but with the excellent results, the advantages of rapid rehablitation and relatively few complications recommends this procedure and technique for wider use of distal tibia fractures.