Interlocking nail and Ender′s nail in management of diaphyseal fracture of tibia in a rural population of a developing country

Abstract

Introduction: Intramedullary nail fixation has become the standard of treatment for tibial shaft fractures. Aims: The aim was to compare the results of the interlocking nail with Ender's nail, which are less expensive in our country for diaphyseal fracture of the tibia. Materials and Methods: This prospective pilot project was conducted on 30 patients after taking institutional ethical clearance and consent of the subjects in a time period of 1-year. Fifteen patients were treated with intramedullary nailing (Group I) in the tertiary care hospital while 15 with Ender's nail (Group II) in a rural hospital (with the lack of modern operative facilities). Results: The skeletal injury was classified according to AO/OTA classification. The majority of the patients were operated in 2 nd week of injury in our study. Average time taken for Ender's nail was 41.33 min and the average time for interlocking nail was 74 min, and the difference was highly significant (P < 0.01). The mean c-arm shot needed 18.66 and 49.00 for Ender's nail and interlocking nail, respectively; which was highly significant (P < 0.01). The majority of Ender nail group were allowed partial weight-bearing after 6 th weeks postoperatively while in interlocking nail group it could be allowed as early as 3 weeks. The majority of cases shows sign of clinical union in 8-12 th week in the interlocking group (%) and 13-16 th week in Ender's nail group. About 60.00% cases in Ender group and 86.66% cases in interlocking nail group had excellent results. Conclusion: Interlocking nails should be the first implant of choice to operate tibial diaphyseal fractures and the use Ender's nails should be done with caution in selected low-demand patients with suitable fracture patterns having financial constraints as well.