Title: Treatment for Lower One Third Fractures of Tibia by Interlocking Nailing
Authors: Suresh Reddy.S, Obulapathy.D.
DOI: http://dx.doi.org/10.18535/jmscr/v3i9.08
Distal tibial fractures remain one of the most substantial therapeutic challenges for Orthopaedic surgeons. Though these fractures can be managed conservatively, operative techniques have been largely superseded for displaced or irreducible fractures and fractures with intra articular extension. However locked intra medullary nail and minimally invasive bridge plate are the two commonly used surgical techniques. The objective of this study was to evaluate the outcome of inter locking nailing (ILN) for treatment of lower one third fracture tibia. 24 adult patients with closed fracture of lower one third tibia without intra articular extension were included in this study and were subjected to inter locking nailing procedure. The follow up period ranged from 6 weeks to 1 year. Johner and Wruch’s criteria was used for evaluation. Results were excellent in 66.6%, good in 25%, fair in 8.3%. This study concludes that closed inter locking nailing was an appropriate method as it showed optimal results and less complications in management of fracture lower one third of tibia. Keywords- Lower one third tibia, closed fracture, intra articular extension, interlocking nailing (ILN). A.Rouhani,A Elmi,H.Akbari Aghdam,F. Panahi,Y.Dokht Ghafari.The role of fibular fixation in the treatment of tibia diaphysis distal third fractures Orthopaedics and Traumatology:Surgery and Research 98(8)2012,868-72. Siddhartha Venkata Paluvadi’ Hitesh Lal. Deepak Mittal and Kandarp Vidyarthi. Management of fractures of the distal third tibia by minimally invasive plate osteosynthesis – A prospective series of 50 patients. J Clin Orthop Trauma. 2014 sep; 5(3):129-136. Pedro Jose Labronici,Jose Sergio Franco,Anselmo Fernandes da Silva et al.Treatment of distal fractures of the tibia.Acta ortop.bras.vol.17 no.1Sao Paulo 2009. Viswanath Yaligod,Girish H. Rudrappa, Srinivas Nagendra and Umesh M Shivanna. Minimizing the complications of intrame-dullary nailing for distal third tibial shaft and metaphyseal fractures.J Orthop.2014 Mar;11(1):10-18. Andreas H. Ruecker,Michael Hoffman, Martin E.Rupprecht,Johannes M.Rueger, Distal tibial fractures: Intramedullary Nailing. Eur J Trauma Emerg Surg 2009.No.6. Robert W.Wysocki,MD,James S. Kapotas, MD,and Walter W. Virkus,MD. Intramedullary Nailing of Proximal and Distal one –third Tibial Shaft Fractures with Introperative Two-Pin External Fixation.J Trauma,2009;66:1135-1139. Distal metaphyseal fractures of the tibia with minimal involvement of the ankle. Classification and treatment by locked intramedullary nailing. Edinburgh Royal Infirmary, Scotland, UK.The Bone & Joint Journal. 10/1995; 77(5):781-7. Johner R and Wruhs O: Classification of tibial shaft fractures and correlation with results after rigid internal fixation. Clin Orthop 1983; 178:7-25. Wu CC, Shih CH. Complicated open fractures of the distal tibia treated by secondary interlocking nailing. J Trauma 1993; 34(6):792-796. AHSM Kamruzzaman,S Islam Result of closed interlocking intramedullary nail in tibial shaft fracture Bang Med J (Khulna)2011;44:15-17. Aso Mohammed, Ramaswamy Saravanan, Jason Zammit and Richard King. Intramedullary tibial nailing in distal third fractures: distal locking screws andfracture non-union. I nt Orthop. 2008 Aug; 32(4):547549. Janssen KW, Biert J, Van KA. Treatment of distal tibial fractures: a retrospective outcome analysis of matched pairs of patients. Int Orthop 2007;31(5):709-71 Vallier HA, Le TT, Bedi A. Radiographic and clinical comparisons of distal tibia fracture (4 to 11 cm proximal to the plafond): plating versus intramedullary nailing. J Orthop Trauma 2008; 22(5):307-11. Im GI, Tae SK, Distal metaphyseal fractures of tibia: a prospective randomized trial of closed reduction and intramedullary nail versus open reduction and plate and screw s fixation. J Trauma 2005; 59(5):1219-23. Guo JJ, Tang N, Yang HL, Tang TS. A prospective, randomized trial comparing closed intramedullary nailing with percutaneous plating in the treatment of distal metaphyseal fractures of tibia. J Bone Joint Surg Br 2010; 92(7):984-88. Teeny S, Wiss DA, Hathava R, Sarimento A. Tibial plafond fractures: Errors, complications and pitfalls in operative treatment. Orthop Trans. 1990; 14:265.Abstract
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