A Clinical Study For Evaluation Of Results Of Closed Interlocking Nailing Of Fractures Of The Shaft Of The Tibia

Abstract

This is a prospective study of the role of closed interlocking nailing of fractures of the shaft of the tibia in 25 cases aged from 18-54 years, out of which 23 (92%) were males and 2 (8%) were females. Th right side was involved in 13 (52%) patients and the left in 12 patients (48%). Motor vehicle accidents were the major cause of the tibial fractures (80%). There were 18 (72%) closed and 7 (28%) open fractures and most of the fractures were either oblique (36%) or transverse (32%) while 20% were comminuted, spiral 8% and 4% were segmental. Reamed closed interlocking nailing was done in most cases under image intensifier. Partial weight bearing was started within the first two weeks in 84% of patients after surgery and full weight bearing was started at 6 weeks. Fracture united in 100% of cases in our series and time of union ranged from 11-28 weeks with the average 14 weeks in 24 cases. Excellent results were found in 18 (72%) cases. In 4 (16%) cases results were good and in two cases results were fair. In one (4%) case result were poor, who had delayed union and deep infection. INTRODUCTION The tibia is the most commonly fractured long bone. The optimal method of treatment for these injuries remains debatable. In spite of all the advances, fractures of the tibia still pose a challenge to the orthopaedic surgeons and thus the management of the fractured tibia requires the widest experience, the greatest wisdom, and the nicest of the clinical judgement in order to choose the most appropriate treatment for particular pattern of injury. That is why Sir John Charnley long back spoke rightly that “we have still a long way to go before the best method of treatment of fractures of the shaft of the tibia can be stated with finality”. Since the advent of intramedullary fixation it has undergone several modifications specially the advent of locking which has widened the rather limited indications of unlocked nailing. When operative fixation is indicated locked I.M. nail at present appears to be an attractive surgical option, as it is the only operative modality closest to the safe yet rewarding and time honoured conservative treatment. The intramedullary interlocking nail can be solid or hollow type and can be used either in static or dynamic mode, may be reamed or undreamed, but however the ideal technique remains a matter of controversy. Presented here is a clinical study for evaluation of results of closed interlocking nailing of fractures of the shaft of the tibia in 25 cases done in the post graduate department of orthopaedics, GMC, Jammu. MATERIAL AND METHODS This is a prospective study of 25 cases of fractures of the shaft of the tibia treated with interlocking nail over a period of 2 years in the Post graduate Department of Orthopaedics, Govt. Medical College, Jammu. Criteria for selection of patients are; AGE; patients in age group of 16 years and above with fresh fractures of the tibia shaft were taken up for closed interlocking nailing as primary treatment.