Functional Outcome of Interlocking Nailing of Type I and Ii Compound Fracture Tibia

Abstract

BACKGROUND Introduction of closed locked intramedullary nailing has revolutionised the management of fractures of femur and tibia. The study is to prove type-I and type-II open fractures with comparatively less soft tissue damage and contamination, can be safely managed by debridement, early wound care and an unreamed/ reamed interlocking nailing without any deep infection hence allowing early mobilisation, reducing morbidity, reducing reoperation/ secondary procedures and malunion/ non-union. MATERIALS AND METHODSA prospective observational study was approved by the Hospital Ethical Committee and an informed consent was taken from all patients. 30 patients who underwent IL nailing from March 2011 to 2012 were enrolled in this study. Of the 30 patients, 17(56.7%) patients had fracture in right tibia and 13(43.3%) had fracture in left tibia. Age of the patients ranged from 18 to 65 years with mean age being 35.5. Males dominated (73.3%) in this study population and the sex ratio was found to be 2.75. Females were represented by only 26.7%. RESULTSIn this study all the cases united irrespective of the Gustilo and Anderson (G and A), OTA classification, Level of fracture and Mode of injury. Time of union ranges between 15 to 24 weeks with mean time of union is 20.1. Shortest time for a union was within 15 weeks (1 case) which was grade I Gustilo and Anderson, middle 3 rd , transverse, OTA-A fracture and maximum time taken was a period of 24 weeks (2 cases) which were type II, lower3 rd fractures. From this, it is observed that there is a difference in union rate between Level, Gustilo and Anderson, and OTA classifications. In this study, it is observed that there were no cases of deep infection. CONCLUSIONClosed interlocking intramedullary nailing is an effective method of treatment for Gustilo and Anderson type I and II compound tibial diaphyseal fractures. It is based on the principle of promoting biological healing and allows gradual weight bearing. Closed nailing and static locking is a technically demanding procedure. Risk of exposure to radiation is there. This method offers the possibility of maintenance of length, alignment and rotational stability in fractures of the tibial shaft, while preserving the biological environment of fracture healing. The fixation is rigid, hence there is no need for external immobilisation prior to callus formation and weight bearing. KEYWORDSCompound Fracture Tibia, Gustilo and Anderson (G and A) Classification, Interlocking Intramedullary Nailing. HOW TO CITE THIS ARTICLE: Baby S, Kunjappan MM. Functional outcome of interlocking nailing of type I and II compound fracture tibia.