Outcome of intramedullary nailing of distal third tibial fractures

Abstract

Fractures of extra articular distal third tibia remain a controversial subject despite advances in treatment care. Various treatment modalities include conservative treatment or operative with fixation of plate or intramedullary interlocking nail. The aim of this study is to determine role of nailing in distal third tibial fractures. Thirty patients with distal third tibial fractures which were treated between January 2017 to June 2018 were included in the study. The mean age of our patients was 36years (18years – 75 years). 20 were male and 10 females. Road traffic accident was the most common mode. The mean delay between injury and surgery was 5days (Range 1-21 days). 28 had concomitant fibula fracture. Intramedullary interlocking nail was applied in all these patients. Two or preferably three distal screws were applied taking care of reduction. The results were analysed with Johner and Wruh’s criteria. All fractures united. Radiological union was achieved at 22.1weeks. 90% had excellent to good outcome as per Johner and Wruh’s criteria. None of the patients had infections, implant failure or any thromboembolic episode. The use of intramedullary interlocking nail is an effective method for distal third tibial fracture treatment.