Intramedullary Interlocking Nail in Distal One Third Tibia Fracture: A Retrospective Study in Tertiary Care Center

Rajiv Baral,Gp Singh,Prakriti Raj Kandel,Bipan Shrestha,Sagar Panthi,Kishor Man Shrestha

doi:10.17554/j.issn.2311-5106.2018.05.273

Abstract

AIM: To assess functional outcome of intramedullary interlocking nail in distal tibia fracture where distal locking screw is applied after inserting proximal locking screw. PATIENTS AND METHOD: This is a retrospective study which was conducted in Universal college of medical sciences. This study was started one year back and last case was followed for one year. All thirty three cases with distal tibia extraarticular fracture 42A1 and 43A3, according to AO classification, within 7 cm from the ankle plafond of skeletally mature person presented in emergency along with Gustillo Anderson (GA) I, II, IIIa and fibula fracture are included in the study. Intrarticular fracture, GAIIIb and lost follow up cases were excluded from the study. Proximal interlocking screws are placed at first followed by distal interlocking screw. Mechanism of injury, age, sex, union time, foot function index, secondary procedure, complications, deformities are analyzed in the study. RESULTS: All patients were retrospectively analyzed. We could not find any significant relation between post operative malalignment and better foot function index (p = 0.975). Early union may not improve overall foot function index (p = 0.202). Automobile accident is the commonest mode of injury (48.5%) followed by automobile pediastrian (39.4%). Postoperative malalignment consist of cornal (3%), saggital (3%) and shortening (3%). Infection is one of the commonest complication found in our study (6.1%).

Highlights

Distal tibia fracture is one of the challenging fractures presented in the emergency department
All thirty three cases with distal tibia extraarticular fracture 42A1 and 43A3, according to AO classification, within 7 cm from the ankle plafond of skeletally mature person presented in emergency along with Gustillo Anderson (GA) I, II, IIIa and fibula fracture are included in the study
All thirty three cases with distal tibia extraarticular fracture 42A1 and 43A3, according to AO classification, within 7 cm from the ankle plafond of skeletally mature person presented in emergency along with Gustillo Anderson(GA) I, II, IIIa were included in the study[5,6]

Summary

Introduction

Various methods are involved in the treatment of this fracture Casting, nailing, plating, external fixator are well known methods of treatment. Plates can be inserted via open reduction internal fixation and minimally invasive technique. Invasive plate technique may have a complication of hardware problem[1]. Intramedullary nailing is one of the popular method of treatment of distal one third tibia fracture but it is not devoid of postoperative complication if not done properly[3]. It is technically demanding procedure and its role in the treatment of distal metaphyseal fractures has not been well defined[4]

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Conclusion