Third Of Tibial Shaft Research Articles

Joshi’s external stabilization system in the management of distal tibial and fibular fractures with associated soft tissue injury in children

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Injuries around ankle and distal third of tibial shaft are among common paediatric bone trauma. Some of these cases are associated with soft tissue injury over the lower third of leg or around the ankle joint as tibia is subcutaneous on the anteromedial aspect. This study was conducted to know the outcome of these injuries with minimal invasive external fixation.</span></p><p class="abstract"><strong>Methods:</strong> Eleven patients in the age group of 4-14 years were included in this study. All patients had closed fracture of distal third tibial shaft or injury of distal tibial physis with associated soft tissue injury. Joshi’s external stabilization system was used to retain the reduction of fracture and appropriate wound care was taken. JESS was removed after radiological signs of fracture union.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Patients were followed up for mean period of 8.9 month. After JESS fixation healing of wound occurred at an average of 12.45 day and external fixator was removed at 6-8 weeks period. Three patients had grade 1 pin tract infection which was controlled by local dressing. No patient had stiffness of ankle at the time of JESS removal. No limb length discrepancy was seen in any of the patients in this study at their final follow up. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">JESS gives good results in fractures of distal tibial with associated soft tissue injury. It helps in better management of wound and fracture stabilization.</span></p><p> </p>

Pattern of Tibial Shaft Fractures in Universal College of Medical Sciences, Bhairahawa: A Review of Sixty Cases

BACKGROUND: Tibia is one of the commonest long bone fracture seen in emergency. Road traffic accidents are the major causes of fracture shaft of tibia. However, studies on these fracture have not been conducted in this part of the world so we conducted this study to identify epidemiological characteristics (age, sex, mechanism of injury, season, source of injury, type of fracture. any associated injury, location, method of treatment and complication) in patients with fracture shaft of tibia admitted in the emergency of Medical College hospital, Bhairahawa. METHODS: This is hospital based prospective observational study conducted at Universal College of Medical Science Teaching Hospital, Bhairahawa (Lumbini zone) among 60 tibial shaft fracture patients in hospital emergency. The study period was from December 2010 to November 2011. RESULTS: All total of 60 tibial shaft fracture in 60 patients with a mean age of 28.35 yrs(3-75yrs) were reviewed. The cause of injury were mostly road traffic accident of which Bike (26.6%,), Bus (6.7%), Car (6.7%), Cycle (10%), Rickshaw (6%), Tractor (6.7%), Truck (1.7%), and Vehicle collision (3.3%) were more prevalent. Other injuries were Bomb blast (1.7%), Fall injury (16.7%), Logroll (3.3%), Sports/football (5.5%) and Stone injury (1.7%) . Distal one third of tibial shaft (49.2%) was the commonest site of fracture. Most of the patients presented between 1st hour to even 10 days of injury. Sixty five percent of the fracture were closed and 35% were open. Most were managed operatively (51.7%). Mean time for union of close type of fracture was 13.78(SD ±2.99) weeks and for open was 16.2 weeks (SD±3.34). Complication included infection in one patient and delayed union in two patients. CONCLUSION: In our present study, most tibial shaft fracture were due to road traffic accident. So, efforts should be made by concerned authorities for improving the roadways system of Nepal as well as provision of standard but affordable health care for victims of road traffic crashes.DOI: http://dx.doi.org/10.3126/jucms.v1i3.8773 Journal of Universal College of Medical Sciences Vol.1(3) 2013: 11-14

Surgical repair of multiple tibial fracture in a Wolf whelf (Canis lupus) by bone plating

Fractures of limbs are common in domestic as well as in wild animals. Fracture reduction, perfect immobilization and postoperative care will decide the success rate in any fracture management in non-infected cases. We present here a successful surgical repair of tibial fracture with bone plating in a Wolf whelf. A eight month old male Wolf pup (Canis lupus) belonging to S.V. Zoological Park, Tirupati was presented to the surgical ward with a complaint of broken right hind limb. The animal was unable to walk and bear weight on right hind limb. Temperature, pulse and respiratory rates were within normal physiological limits. On palpation, swelling, crepitus and pain was observed. At the proximal third of tibial shaft. Radiographic examination revealed complete, multiple fracture of proximal third of right tibial shaft. Fractured bone chips were also noticed (Fig. 1). Based on these findings, it was decided to perform surgery. Triflupromazine hydrochloride @ 2 mg/kg body weight was given intramuscularly as preanaestheti c 15 minutes before surgery. The animal was anaesthetized with 25% solution of Thiopentone sodium @ 25 mg/kg body weight given intravenously. The tibia was approached from medial aspect by incising the skin and separating muscles. After avoiding blood vessels and nerves, proximal and distal fracture segments were isolated. Sharp edges were removed. The two fractured ends were kept in alignment and immobilized and six holed sherman bone plate was applied over it. The screws were snugly fit up to opposite cortex. The plate was kept in position by wires (Fig. 2). Demineralized bone matrix powder was poured at the fractured site to enhance healing and bone formation. Streptopenicillin powder was applied over the operative site after removing blood clots. The muscles were sutured using no.1 chromic catgut by interrupted suture technique. Shin incision was closed using no.1 silk by horizontal mattress suture technique. Tincture benzoin seal was applied to the suture line. Streptopenicillin 0.5 grams and Diclofaenac sodium 2 ml. was given intramuscularly for five post operative days. Modified Thomas splint was applied to the limb for perfect immobilization. The animal made uneventful recovery without any complications.