Surgical management of diaphyseal fractures of tibia with intramedullary interlocking nailing in adult patients

Abstract

Background and Objectives: Fracture shaft of tibia are increasing due to high velocity trauma and industrialization. Not only are they common but often difficult to treat. Previously surgeons had to rely on non operative methods, ‘V’ nailing, ‘plates and Screws’ and external fixators but they had their known drawbacks like prolonged immobilization, infection, delayed union, nonunion, malunion and cumbersome for patients, with the introduction of intramedullary interlocking nail for tibial shaft fractures has overcome some of these complications and encourages the patients for early mobilization. This study has been done to evaluate the functional results and complications of intramedullary interlocking nail for tibial diaphyseal fractures of closed type. Methods: Fifty adult patients with fresh tibial shaft fractures were treated surgically with intramedullary interlocking nail between December 2014 to march 2016. Results: Among fifty patients treated with intramedullary interlocking nail, fractures united with a union rate of 94%. Two fractures showed delayed union, one fractures had non union and one fracture had malunion. One case had distal locking screws breakage. Two cases of superficial infection were noted. Seven patients had anterior knee pain, one case developed shortening of leg which was less than 1cm. Functional results were graded according to the criteria by Klemm and Borner. 92% of patients achieved good or excellent results, fair results were obtained in one patient and in one patient the functional results were poor. Conclusion: This study with fresh fractures of the tibia (closed type, transverse and short oblique) treated with intramedullary interlocking nailing is a safe and effective technique for management of closed tibial diaphyseal fractures with high union rates, low incidence of complication. Good functional results are achieved by careful preoperative planning and respecting the principles of intramedullary interlocking nailing technique.