A prospective study of functional outcome of expert tibia nail in upper third tibial fractures

Abstract

Background: This was a prospective study of functional outcome of expert tibia nail in upper third tibial fractures.
Material and methods: The present prospective clinical study was conducted for a period of 18 monthson 30 patients with proximal fractures of tibia admitted under the department of Orthopedics of VIMS, Ballari. All these patients were clinically and radiologically confirmed with proximal third fractures of tibia, and were eligible for the study. After carrying out necessary laboratory investigations and obtaining physical fitness for surgery, the subjects were surgically managed with Expert tibial nailing fixation. Further, the patients were followed up post operatively and at 3, 6 and 12 months regularly until the union was achieved both clinically and radiologically. Results: Majority belonged to the age group of 31 to 40 years (40.0%). Majority were males (73.3%), and the most common mode of injury was road traffic accidents (83.3%). The most common type of fracture was closed fracture (70.0%),
followed bytype I GA open fractures (23.3%). About 40.0% cases suffered associated injuries which include ipsilateral fibula fracture, head injury, rib fracture and opposite limb injury. Based on modified KLEMM and Borner scoring system, the functional outcomewas excellent in majority(66.7%). The mean duration for radiological union was 22.03 ±2.62 weeks. Skin infection and anterior knee pain were the commonest complications.The study found statistically significant relation only in terms of age, type of fracture, presence of associated injuries and complications, thereby suggesting that younger theage of the subjects, simple the fracture, absence of associated injuries and complications, better was the functional outcome in the study. Conclusion: The functional outcome of Expert tibial nailing technique was excellent in about two third of cases with extra articular upper 1/3rd proximal tibial fractures. The union time for the fracture treated by Expert tibial intramedullary nailing was around 5-6 months. Anterior knee pain and skin infection were the commonest complications of Expert tibial intramedullary nailing of tibial fractures.