Management of tibial shaft fractures with reamed intramedullary interlocking nail: A prospective study

Abstract

Fracture shaft of tibia are increasing due to high velocity trauma and industrialization. Not only they are common but often difficult to treat. Until recently surgeons had to rely on non operative methods, ‘V’ nailing, ‘plates and Screws’ and external fixators but they had their drawbacks like prolonged immobilization, infection, delayed union, nonunion, malunion and cumbersome for patients. With the introduction of reamed intramedullary interlocking nail for tibial shaft fractures, it has overcome some of these complications and encourages the patients for early mobilization. This study has been done to evaluate the results and complications of reamed intramedullary interlocking nail for tibial shaft fractures in closed and Gustilos type I and II fractures. Thirty adult patients with fresh tibial shaft fractures were treated surgically with reamed intramedullary interlocking nail. Results: Among thirty patients treated with reamed intramedullary interlocking nail 24 fractures united at an average of 19.12 weeks with an union rate of 96%. Two fractures showed delayed union, one fractures had non union and one fracture had malunion. One case had distal locking screws breakage. One case of deep infection and 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.