Unreamed Solid Locked Nailing In The Treatment Of Compound Diaphyseal Fractures Of The Tibia.

Abstract

This is a prospective study based on 30 cases of compound tibial diaphyseal fractures fulfilling our inclusion criteria and stabilised with primary unreamed solid AO tibial locked nailing with a follow up ranging from 6-18 months.26 cases (87%) were males and 4(13%) were females. 63% of the patients were in the age group of 21-40 years. Open fractures were classified as per Gustillo’s. Road traffic accidents were responsible for most of the fractures (80%) followed by fall from height(10%). 16 cases(53.3%) were statically locked and 14 cases(46.6%) were locked dynamically. All the fractures united in an average period of 22weeks.Evaluation of results was done after one year follow up as per criteria laid down by Johner & Wruhs(1983).Postoperatively, there were 4 cases of superficial infection(13.3%) & 2 cases(6.6%) of deep infection.2 cases(6.6%) had skin necrosis leading to sloughing of skin. Delayed union occurred in 8cases(26.6%).Shortening of >1cm was noticed in one case.As per criteria laid down by Johner & Wruhs 40% cases had excellent result, 50% good results, 10% cases fair & none had poor result. Results were evaluated and compared with various studies.On the basis of above study it was concluded that unreamed solid AO locked nailing is a good mode of primary internal fixation of compound fractures of tibia(grade I-IIIB) and has proved to be a one time procedure, which allows early weight bearing, minimises the chances of infection and delayed union.