A prospective study on clinical outcome of primary nailing in open Type I to Type IIIA tibial diaphyseal fractures

Kiran Hari, K. Srinath, Ravi M Daddimani
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Abstract

Background and Objectives: Tibia is a superficial long bone, with one third of its surface being subcutaneous. An increasing incidence of road traffic accidents, farm accidents, gunshot wound predisposes it for open fracture. Open fractures of the tibia are the most common open long bone fractures. High-energy trauma is the primary mechanism of injury, with over 50% of cases being attributed to road traffic accidents are frequently contaminated. The treatment of open tibia fractures is still controversial. This prospective study was conducted at a tertiary care trauma center to evaluate the functional outcome and complications following primary debridement and nailing in type I to type IIIA open tibia fractures. Materials and Methods: A total of 30 patients diagnosed with open tibial diaphyseal fractures, who underwent primary debridement and fixation with intramedullary interlocking nail were included in the study and type III B, type III C open fractures were excluded. Patients were followed for a period of 12 months and assessed using Modified Ketenjian criteria and Johner − Wruhs' criteria. Results: Out of 30 patients who underwent primary nailing for open tibia fractures, 66.67% had excellent, 26, 67% good, and 6.66% of patients had fair results. 93.33% of the patients had union within 9 months and 6.66% of the cases had delayed union. Conclusion: Primary intramedullary interlocking nailing in open tibia fractures is a good treatment option, it aids early patient mobilization and early resume to work. It avoids multiple surgical procedures and promotes early fracture union.
Ⅰ型至ⅢA型开放性胫骨骨干骨折一期内钉治疗的前瞻性研究
背景与目的:胫骨是一种浅表长骨,三分之一的表面为皮下。道路交通事故、农场事故、枪伤的发生率越来越高,容易导致开放性骨折。胫骨开放性骨折是最常见的开放性长骨骨折。高能创伤是损伤的主要机制,超过50%的道路交通事故病例经常受到污染。开放性胫骨骨折的治疗仍然存在争议。这项前瞻性研究是在三级护理创伤中心进行的,目的是评估I型至IIIA型开放性胫骨骨折一期清创和钉扎后的功能结果和并发症。材料与方法:本研究共纳入30例诊断为开放性胫骨骨干骨折的患者,他们接受了一期清创术并用髓内交锁钉固定,排除了III-B型、III-C型开放性骨折。对患者进行为期12个月的随访,并使用改良的Ketenjian标准和Johner−Wruhs标准进行评估。结果:在30例胫骨开放性骨折患者中,66.67%的患者表现良好,26%、67%的患者效果良好,6.66%的患者效果尚可。93.33%的患者在9个月内愈合,6.66%的患者延迟愈合。结论:一期交锁髓内钉治疗开放性胫骨骨折是一种良好的治疗选择,有助于患者早期动员和早期恢复工作。它避免了多次手术,并促进骨折早期愈合。
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17 weeks
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