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- Title
FUNCTIONAL OUTCOME OF DISTAL TIBIAL METAPHYSEAL AND META-DIAPHYSEAL FRACTURES IN ADULTS TREATED BY TIP LOCKING INTRAMEDULLARY NAIL.
- Authors
RAJENDRAN, JIBI; KRISHNAN, JOJI; RAFFIC, M.
- Abstract
Background Distal tibial metaphyseal fractures are caused by high-energy axial compressive, direct bending or low energy rotational forces. It represent less than 7% of all tibial fractures and less than 10% of all lower extremity fractures. The fractures distal to the tibial diaphysis and within 5 cm of the ankle joint may represent a different injury, and hence has been excluded from reports on intramedullary nailing of tibial shaft fractures. The proximity to the ankle joint may further amplify the bending moment of the short distal segment and may allow fracture propagation into the ankle joint. This study is to assess the union of fractures and to evaluate the functional outcome of patients with distal tibial metaphyseal and dia-metaphyseal fractures treated with newer generation intramedullary interlocking nailing. Materials and Methods The study included thirty eight patients belonging to adult age group presented with distal tibial metaphyseal and dia-metaphyseal fractures from January 2012 to June 2013. All patients were treated with tip locking intramedullary interlocking nailing with distal most locking option. Final assessment was done at 6 months as per Johner and Wruh's criteria with modification taking into account of the following objective and subjective symptoms of gait, pain, deformity, range of motion of knee and ankle joints, shortening, neurovascular injury and presence or absence of non-union/infection. Functional outcome was graded into excellent, good, fair and poor. Results The results of tip locking intramedullary interlocking nailing for distal tibial metaphyseal and dia-metaphyseal fractures were excellent in 30 patients (78.9%), good in 6 patients (15.8%) and fair in 2 patients (5.3%). The average healing time was 16.7 weeks. There were 3 patients with anterior knee pain (7.9%), 2 patients with superficial infections (5.3%) and 2 with minimal shortening (5.3%). Conclusion Tip locking intramedullary interlocking nailing is a reliable method of treatment for distal metaphyseal and dia-metaphyseal fractures because of its excellent and good results. The advantage of rapid rehabilitation and relatively few complications serve to recommend it for wider use.
- Publication
Kerala Journal of Orthopaedics, 2014, Vol 27, Issue 2, p88
- ISSN
2249-233X
- Publication type
Academic Journal