A study of management of tibial diaphyseal fractures with intramedullary interlocking nail: A study of 50 cases

Rathwa, Yograj M; Desai, Tarun; Moradiya, Niravkumar; Joshi, Parth; Joshi, Poojan A

doi:10.22271/ortho.2017.v3.i1e.47

Cited by 4 publications

(3 citation statements)

References 5 publications

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“…They account for approximately 2% of all adult fractures (1) and are commonly a result of high energy trauma injuries (2). There are several fixation methods available and intramedullary nails have demonstrated a good track record of allowing earlier weight bearing and achieving acceptable union rates, alignment, reoperations and infection incidences (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

Comparison of dynamic versus static fixation of intramedullary nailing in tibial diaphyseal fractures: A systematic review and meta-analysis

Loh¹,

Onggo²,

Hockings³

et al. 2022

Journal of Clinical Orthopaedics and Trauma

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Section: Introductionmentioning

confidence: 99%

Comparison of dynamic versus static fixation of intramedullary nailing in tibial diaphyseal fractures: A systematic review and meta-analysis

Loh¹,

Onggo²,

Hockings³

et al. 2022

Journal of Clinical Orthopaedics and Trauma

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“…The problem that usually occurs in patients who experience non-articular tibia fractures is the length of the healing process, muscle atrophy, reduced bone density, delayed union, and non-union. The process of fracture healing is influenced by several factors such as; osteoblast activity, fracture type, nutritional status, care, psychological conditions, time of medical intervention and rehabilitation as early as possible [5], [6]. Patients after open reduction internal fixation of the tibia fracture are long enough for several weeks without weight bearing which can cause complications in the form of calf muscle atrophy, calf muscle weakness, osteopenia, limited motion of the knee joint, and ankle [7].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Isometric Exercise Plantar Flexor on Osteoblast Activity Measured by Bone Specific Alkaline Phosphatase and Callus Formation in a Patient Post Open Reduction Internal Fixation with Non-articular Tibia Fracture

Taufik¹,

Tulaar²,

Moesbar³

et al. 2019

Open Access Maced J Med Sci

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BACKGROUND: Post-operative non-articular tibia fracture several problems that can occur include; pain, muscles atrophy, muscles weakness, joint stiffness, delayed union, and non-union that makes patients limited in their daily activities. Several factors that play a role in the process of fracture healing include osteoblast activity and exercise. Isometric exercises plantar flexor might effectively prevent the problem. Markers of osteoblast activity are bone-specific alkaline phosphatase (BSAP) levels and Hummer scale callus formation. Not yet known the effect isometric exercise of plantar flexor on osteoblast activity in the post open reduction internal fixation of non-articular tibia fractures, due to the lack of studies in this field. AIM: This research was conducted to investigate the effect of isometric plantar flexor on osteoblast activity and callus formation in patients post open reduction internal fixation nonarticular tibial fractures. HYPOTHESIS: There are differences in osteoblast activity and callus formation between groups that do isometric exercises of plantar flexor muscles with those that without isometric exercises plantar flexor. ANALYSIS: Hypothesis test used a paired t-test with a value of α 0.05 and a confidence level of 95%. METHODS: This clinical trial was true experimental with pre-post test control group design divided into two groups, group I obtained treatment of isometric exercises of the plantar flexor muscle, range of motion knee joint, and ankle while group II obtained the range of motion knee joints and ankle. Osteoblast activity measured with bone-specific alkaline phosphatase level and callus formation. RESULTS: The result of the study found to increase mean bone-specific alkaline phosphatase group I; 15.6 and group II; 5.2. A paired t-test of independent samples with α of 0.05 and confidence interval 95% was obtained p-value = 0.000, there is a significant difference in increased levels of bone-specific alkaline phosphatase group I obtained isometric exercises plantar flexor with group II without isometric exercises plantar flexor in patients post open reduction internal fixation of a non-articular tibia fracture. Radiographic examination of Hummer scale callus in group I who carried out isometric exercises plantar flexor had an average value of 2.63, whereas group II without isometric exercises plantar flexor average of 3.06. Wilcoxon test with a 0.05 and 95% confidence interval obtained p-value = 0.000, there is a significant difference in callus image in both groups of patients post open reduction internal fixation non-articular tibia fracture. The linear regression calculated of callus assessment with bone-specific alkaline phosphatase obtained the value of R quadrat = 0.793, which showed that the formation of callus Hummer classification could predict the change in bone-specific alkaline phosphatase value by 79%. CONCLUSION: The research found isometric exercise plantar flexor in patients post open reduction internal fixation non-articular tibia fracture enhances osteoblast activity and callus formation that will likely short the healing process time and prevent delayed union or non-union.

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“…Than AO came up with the concept of indirect and functional reduction and relative stability in diaphyseal fractures and gave more importance to secondary bone healing which is more Biological and needs less soft tissue dissection [7] . As such, intramedullary nails become the gold standard for the treatment of diaphyseal fractures in the lower limb [8] . But it was not indicated in open fractures because it was thought to aggravate complications like infection.…”

Section: Introductionmentioning

confidence: 99%

Prospective randomized study of outcome of intramedullary interlocking nail as primary fixation method in grade 1 & 2 compound fractures of tibia

Shekhawat¹,

Verma²,

Jangir³

et al. 2019

Int. J. Orthop. Sci.

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Fractures of tibia shaft is itself a great dilemma and becomes more difficult to treat when it becomes a compound fracture. So in this new era of fast paced technologies, an aggressive approach is required to treat such fractures in view of early rehabilitation and return to occupation. This prospective randomized study was conducted at department of Orthopedics in Mahatma Gandhi Medical College and Hospital, Sitapura, Jaipur to evaluate outcomes of intramedullary interlocking nail as primary fixation method in compound fractures of tibia. Surgery duration was less in intramedullary nail because in most of the cases fractures were easily reduced, minimal surgical exposure and associated less closure time. Intra operative image intensifier use was significantly more because of distal screw locking and determination of nail length. Post operatively aim of the treatment was to make the patient upright, and start weight bearing as early as possible as per the personality of fracture. In follow up of cases at 12 and 24 weeks as per functional outcomes patients had very mild difficulty in performing activities of daily living. On concluding the outcome as per Johner and Wruhs Criteria at 24 weeks excellent score was found in 70% cases of ILN while it was poor in 5% cases and remaining had good to fair outcomes.

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A study of management of tibial diaphyseal fractures with intramedullary interlocking nail: A study of 50 cases

Cited by 4 publications

References 5 publications

Comparison of dynamic versus static fixation of intramedullary nailing in tibial diaphyseal fractures: A systematic review and meta-analysis

Comparison of dynamic versus static fixation of intramedullary nailing in tibial diaphyseal fractures: A systematic review and meta-analysis

The Effect of Isometric Exercise Plantar Flexor on Osteoblast Activity Measured by Bone Specific Alkaline Phosphatase and Callus Formation in a Patient Post Open Reduction Internal Fixation with Non-articular Tibia Fracture

Prospective randomized study of outcome of intramedullary interlocking nail as primary fixation method in grade 1 & 2 compound fractures of tibia

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