2019, Vol. 3 Issue 4, Part A
Tibia is not only the most common long bone of body to get fractured but also offers many challenges to Orthopaedic surgeons in managing its fractures. Since tibia lies directly below the skin in most of its course, it is not only prone to get open fractures very commonly but also prone to get wound problems after any fracture fixation surgery. There are various options available for the surgical management of distal 1/3rd
tibial shaft fractures and each of these treatment options is associated with certain challenges.
Method: We studied the 60 patients of distal 1/3rd tibial shaft fractures operated with closed reduction and internal fixation with reamed intramedullary interlocking nailing. Radiological outcomes and clinical outcomes using Olerud-Molander score were assessed at 6 weeks, 3 months, 6 months and 1 year intervals.
Result: In our study, 28.44% patients were in 36-45 years age group, followed by 23.23% in 16-25 & 26-35. Males were 71.67% where females were 28.33%. Road Traffic Accident were maximum 70% in mode of injury, followed by fall from height 23.33%. Percentage of patients in which fibula was fixed was 16.66%. Mean for surgery duration in minutes was 85.08.
Percentage of Patients with Complication of Wound Infection was 05%. Mean of Olerud-Molander Score was 19.25 at 6 weeks, 32.33 at 3 months, 50.08 at 6 months and 85.58 at 1 year. Mean of Time of Union in weeks was found to be 19.83. We found out that 40% patients had Excellent & 60% patients had good results.
Conclusion: Intramedullary nailing for the management of distal 1/3rd tibial shaft fractures appears to be a good modality of treatment in terms of good union rate, less wound complications and good functional outcome. Use of appropriate surgical procedure, concurrent fibula fixation, distal locking with 3 screws and appropriate post operative rehabilitation gives satisfactory results.