Comparative study of static versus dynamic intramedullary nailing of tibia

Abstract

Worldwide osteoarthritis is the most common joint disorder. It results from mechanical and biological events that destabilize the normal processes of degradation and synthesis of articular cartilage chondrocytes, extracellular matrix and subchondral bone. These changes include increased water content, decreased proteoglycan content and altered collagen matrix, leading to the degeneration of articular cartilage. There is trend on rise to use platelet rich plasma to promote healing of the degenerated cartilage. The aim of the study was to evaluate whether the newer method i.e platelet rich plasma has any significant advantage. The study included a total of 50 cases with individuals ageing greater than 40 years. Patients without evidence of degenerative arthritis and with KL grade 3 and grade 4 were excluded from the study. At 1 month only 14% cases showed excellent, 68% cases showed and. 18% cases showed fair results. At 3 months follow up 16% cases showed excellent, 82% cases showed good and fair results were seen in 2% cases. No case had poor results. At 6 months follow up 16% cases showed excellent, 86% cases showed good and 6% cases showed fair results and no case had poor results. Platlet rich plasma is an excellent method of treatment in early osteoarthritis of knee.

Effects of Dynamization on Delayed Union of Tibial Shaft Fractures After Reamed Intramedullary Interlocked Nailing

“…The mean age of our study population was 39.42+13.79 years. Another study done by Somani had almost similar age 15 . In the current study, the mean height was 163.1+12.3 cm and the mean BMI was 26.8+6.3 kg/m 2 .…”

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

“…61 full text articles were evaluated and a total of 9 studies were included for analysis. There were 7 retrospective cohort (13)(14)(15)(16)(17)(18)(19), 1 prospective cohort (20) and 1 case control studies (21) included in the meta-analysis. Seven studies analysed mean time to union (13-17, 20, 21), four studies analysed delayed union, non-union and reoperation rates (16,17,19,21), while three studies analysed malrotation (13,17,18) and malunion rates (17,19,21).…”

“…However, limitations have also been reported with dynamic Intramedullary nailing. High levels of unrestrained compression in dynamic nailing systems may theoretically cause bone resorption, osteonecrosis at the fracture site (15) ,eventual bone shortening (17,30) and lead J o u r n a l P r e -p r o o f to higher risk of rotational instability (15,31). This could cause leg length discrepancies, nonunion and ongoing pain at the site of fracture.…”

“…Despite this encouraging finding, dynamic nailing may not be suitable for all fracture types. Dynamic nailing systems have been suggested to be most suitable for tibial diaphyseal fractures with limited comminution (AO type A and B, or Winquist type 1 and 2 fractures), and may cause malunion in highly comminuted tibial fractures (AO type C or D fractures and Winquist type 3 and 4 fractures) (17,21). Highly comminuted fractures are often statically fixed to leverage on increased stability and thus reducing risk of malrotation (20).…”

“…patients across the 5 studies. Only 2 studies(17, 21) reported the gender of patients receiving each fixation method. 45 males and 20 females received static fixation while 49 males and 13 females received dynamic fixation across the 2 studies.…”