Determinants of re-operation following tibia intramedullary nailing at a tertiary hospital in south-west Nigeria

Abstract

Introductionintramedullary nailing is a method of choice in the management of long bone diaphyseal fractures. However, complications necessitating re-operation may arise. This study was aimed at determining the rate and indications for re-operation following intramedullary nailing of tibia shaft fractures.Methodsit was a cross-sectional study done at Orthopaedic Department of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife in Southwest Nigeria. Records of patients who had interlocking nailing for tibia shaft fracture between 2005 and March 2013 were retrieved. Variables of interest extracted included aetiology of fracture, type of fracture, cadre of surgeon and indication for re-operation. Frequency distribution and chi-square analysis were done using SPSS version 22. Level of statistical significance was determined at p-value <0.05ResultsOne hundred and forty-six patients had tibia nailing done during the study period. Eighty-six patients met the study criteria with male to female ratio of 2.6:1. There were 51 (59.3%) with open fractures and 35 (40.7%) with closed fractures. Ten patients had re-operation giving a re-operation rate of 11.6 %. Two most common indications for re-operation included loose screw 3 (25%) and surgical site infection (SSI) 3 (25%). There was no statistically significant association between rate of re-operation and the cadre of surgeon (p=0.741) and type of fracture whether closed or open (p=0.190).ConclusionRe-operation following tibia intramedullary nailing is an ever present risk. Precautions should be taken to prevent the common indications such as loose screw and surgical site infections.

Reamed compared with unreamed nailing of tibial shaft fractures: Does the initial method of nail insertion influence outcome in patients requiring reoperations?

“…Reoperation not only exposes patients to perioperative risks associated with surgery, but also provides no guarantee that additional complications will not occur. 3 , 10 Patients experiencing their first postoperative complication may be at a greater risk of a subsequent complication than the whole population. Thus, it is important to identify factors that are associated with multiple reoperations.…”