Use of poller screw in proximal and distal metaphyseal fractures of tibia treated with intra-medullary inter-locking nail: A prospective study of 25 patients

Abstract

Introduction: Treatment of tibia metaphyseal fractures is still difficult. Interlocking tibial fractures is preferred because it allows for some load sharing, preserves extraosseous blood flow, avoids major soft tissue dissection, and is well-known by most surgeons. Nailing of metaphyseal fractures with a short proximal or distal fragment is linked to increased malalignment, especially in the coronal plane, non-union, and the necessity for subsequent treatments to accomplish union. Blocking screws (poller screws), temporary unicortical plating, alternative nail designs with variable proximal bends (proximal third fractures), and fibular plating have all been proposed to better nailing metaphyseal fractures (distal third fractures).''The study's goal was to see if poller screws might be used as a supplement to stability in tibia metaphyseal fractures treated with a statically locked intramedullary nail. Materials and Methods: It was a prospective trial in which 25 patients with extraarticular Tibia metaphyseal fractures presented between July 2020 and December 2021 were treated with an Intra-Medullary Inter-Locking nail augmented with Poller screws and observed for six months. Results: The average age was 45.92 years, with a male majority. "The most prevalent type of injury was on the right side, and the majority of these injuries were caused by car accidents.'' The average time it took for a fracture to heal was 11.45 weeks. Sanders' average score was 36.76, with 9 patients receiving excellent outcomes, 11 receiving good results, and 5 receiving fair results. Conclusion: We conclude that Poller screws, when supplemented the intramedullary interlocked nail of metaphyseal fractures of tibia, 1. Were effective in achieving the fracture alignment, acting as a reduction tool. 2. Improved the stability of the bone – implant construct, by functionally reducing the medullary width. 3. Maintained the fracture alignment till union, preventing loss of initial reduction.