EFFICACY AND SAFETY OF INTERLOCKED INTRAMEDULLARY NAILING FOR OPEN FRACTURE SHAFT OF TIBIA
AbstractBackground: Due to increasing population and changing human habits the number of accidents and high energy trauma is rising. Management of open fracture tibia is a complex problem and is a challenge for both orthopaedic and plastic surgeons. The study was carried out to ascertain the efficacy and safety of interlocked intra-medullary nailing for open shaft tibial fractures in patients presenting at or after 24hr of injury. Methods: In this descriptive case series, over a period of 6 moths, 163 consecutive cases of open fracture of tibial shaft were reviewed in terms of clinical profile, time of presentation, and gender distribution. Results: In this study mean age was 30±0.02 years. Males comprised 85% of study population while 15% were females. Gustilo-I type fracture and Gustilo-II type fracture was diagnosed in 90% and 10% patients respectively. Thirty three percent patients had wound infection while fracture union was found in 15% cases. Moreover interlocked intramedullary nailing for open fracture shaft of tibia was safe in 80% patients while this procedure was effective in 85%. Conclusion: Un-reamed, interlocked intra-medullary nailing may be considered as a suitable option for treatment of open fractures of tibia.Keywords: Tibia, intramedullary nailing, open fractures shaft
Whittle AP. Fractures of Lower Extremity. In: Canale ST, Beaty JH, editors. Campbell’s Operative Orthopaedics. 11th ed. Philadelphia: Mosby Elsevier 2008;3085–236.
Zalavras CG, Marcus RE, Levin LS, Patzakis MJ. Management of open fractures and subsequent complications. Instr Course lect 2007;57:51–63.
Sahibzada AS, Khan MA, Khan MS. Management of tibial bone defect due to high energy trauma using the locally manufactured external fixator by segmental bone transport. J Ayub Med Coll Abbottabad 2005;17:68–72.
Kundu ZS, Sangwan SS, Jain S, Mittal R, Siwach RC, Bhardwaj G. Infected non-union of tibia-management by simple fixator-compressor. Indian J Orthop2004;38(3):162–5.
Cross WW 3rd, Swiontkowski MF. Treatment principles in the management of open fractures. Indian J Orthop 2008;42(4):377–86.
Naique SB, Pearse M, Nanchahal J. Management of severe open fractures: the need for combined orthopaedic and plastic surgical treatment in specialist centres. J Bone Joint Surg Br 2006;88(3):351–7.
Babhulkar S, Raza HR. Open fractures. Indian J Orthop 2008;42(4):365–7.
Chaldis BE, Petsatodis GE, Sachinis NC,Dimitriou CG,Christodoulou AG. Reamed interlocking intramedullary nailing for the treatment of tibial diaphyseal fractures and aseptic nonunions. Can we expect an optimum result? Strategies Trauma Limb Reconstr 2009;4(2):89–94.
Ali A, Anjum MP, Humail SM, Qureshi MA. Results of interlocking nail in tibial diaphysial fractures. J Pak Orthop Assoc2009;21:36–44.
Ilyas M, Idress M, Tareen S. Interlocked intramedullary nailing of long bones. Professional Med J 2008;15:449–54.
Khan IS, Malik RH. Comparison of early and delayed internal fixation of the fracture shaft of femur at Pakistan Institute of Medical Sciences (P.I.M.S.) Ann Pak Inst Med Sci 2005;1(3):124–7.
Glueck DA,Charoglu CP, Lawton JN.Factors associated with infections following open distal radius fracture: Hand (NY) 2009;4(3):330–4.
Brown PW, Urban JG. Early weight-bearing treatment of open fractures of the tibia. An end-result study of sixty-three cases. J. Bone Joint Surg Am 1969;51(1):59–75.
Puno RM, Teynor JT, Nagano J, Gustilo RB. Critical analysis of results of treatment of 201 tibial shaft fractures. Clin Orthop Relat Res1986;212:113–21.
Bach AW, Hansen ST Jr. Plates versus external fixation in severe open tibial shaft fractures. A randomized trial. Clin Orthop Relat Res1989;241:89–94.
Ruedi T, Webb JK, Algower M. Experience with the dynamic compression plate (DCP) in 418 recent fractures of the tibial shaft. Injury 1976;7(4):252–7.
Smith JEM. Results of early and delayed internal fixation for tibial shaft fractures. A review of 470 fractures. J Bone Joint Surg Br1974;56B(3):469–77.
Klein MP, Rahn BA, Frigg R, Kessler S, Perren SM. Reaming versus non-reaming in mdullary nailing: interference with cortical circulation of the canine tibia. Arch Orthop Trauma Surg 1990;109(6):314–6.
Kessler SB, Hallfeldt KK, Perren SM, Schweiberer L. The effects of reaming and intramedullary nailing on fracture healing. Klin Orthop Relat Res1986;212:18–25.
Joshi D, Ahmed A, Krishna L, Lal Y. Unreamed Interlocking nailing in open fractures of tibia. JOrthop Surg (Hong Kong) 2004:12(2):216–21.
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.