Early Outcomes of Intramedullary Interlocking Nail in Closed Tibial Diaphyseal Fractures
Keywords:
Outcomes, Intramedullary Interlocking Nail, Closed, Tibial Diaphyseal fractures, Descriptive study, Pakistan, JPMCAbstract
Objective: To evaluate the early outcome of intramedullary interlocking nailing in closed tibial diaphyseal fractures within the Pakistani population.
Methodology: This Prospective descriptive study was conducted from April to October 2019 at the Department of Orthopedics, Jinnah Postgraduate Medical Centre, Karachi. A total of 81 patients aged 25–65 years with tibial diaphyseal fractures of either gender were included. Patients with ipsilateral femur fractures, chronic renal failure, and chronic liver disease were excluded. A consultant orthopedic surgeon performed intramedullary interlocking nailing. Postoperatively, all patients were prescribed co-amoxiclav 1 g and diclofenac sodium twice daily for two weeks. Patients were followed fortnightly for 3 months, and outcomes were assessed as excellent, good, fair, or poor according to operational definitions. The data were analyzed using SPSS version 20.0. Categorical data are presented as percentages and of numerical means. Excellent outcome associations are portrayed using Chi-square, and a p-value of <0.05 was considered significant.
Results: The mean age was 38.83 ± 7.83 years, with 66 (81.48%) patients aged 25–45 years. The male-to-female ratio was 3:1, with 61 (75.31%) males and 20 (24.69%) females. Outcomes showed that 62 (76.54%) patients achieved excellent results, 8 (9.88%) had good results, 9 (11.11%) had fair results, and 2 (2.47%) had poor results. No significant association was observed between participant characteristics and the clinical outcome of patients with IMN for closed tibial fractures.
Conclusion: Intramedullary interlocking nail demonstrated a high rate of excellent outcomes in the management of close tibial diaphyseal fractures.
References
1. Larsen P, Elsoe R, Hansen SH, Graven-Nielsen T, Laessoe U, Rasmussen S. Incidence and epidemiology of tibial shaft fractures. Injury. 2015; 46(4): 746-50.
2. Guzmán-Juárez L, Galindo-González G, Hernández-Romano P. High Energy Trauma in Relation To the Genesis of Non-Union in Tibial Shaft Fractures. Clin Rev Cases. 2023; 5(2): 1-4.
3. Larsen P, Elsoe R, Hansen SH, Graven-Nielsen T, Laessoe U, Rasmussen S. Incidence and epidemiology of tibial shaft fractures. Injury. 2015; 46(4): 746-50.
4. Courtney PM, Bernstein J, Ahn J. In brief: closed tibial shaft fractures. Clin Orthop Relat Res. 2011; 469(12): 3518-21.
5. Turley L, Barry I, Sheehan E. Frequency of complications in intramedullary nailing of open tibial shaft fractures: a systematic review. EFORT Open Reviews. 2023; 8(2): 90-9.
6. Khan I, Javed S, Khan GN, Aziz A. Outcome of intramedullary interlocking SIGN nail in tibial diaphyseal fracture. J Coll Physicians Surg Pak. 2013; 23(3): 203-7.
7. Venkata Ranganath K, Mayasa V, Reddy VN, Chandran MP, Anuradha N, Karthikeyan S. Management of tibial shaft fractures with closed intramedullary interlocking nail among Indians. Bioinformation. 2022; 18(6): 562-5.
8. Kushwaha MP, Mourya V. Functional and Radiological Outcomes with Intramedullary Interlocking Nailing of Tibial Shaft Fracture. Med Phoenix. 2022; 7(1): 83-7.
9. Bhandari PB, Karki DB, Bisht R, Serchan B. Functional Outcome of Solid Intramedullary Interlocking Nail in Tibial Diaphyseal Fractures. NOAJ. 2021; 8(2): 7-10.
10. Kangbai DM, Clemens-Kangbai N, Smalle IO. Evaluation of the treatment outcome of tibia shaft fracture by close reduction and internal fixation with interlocking intramedullary nail, Freetown, Sierra Leone, 2023. Open Journal of Trauma. 2024; 8(1): 011-20.
11. Al-Sharaa MB, Hashim FW, Al-Edanni MS. Functional outcome of interlocked intramedullary nailing fixation in management of closed tibia shaft fractures. Rawal Med J. 2021; 46(4): 890.
12. Habib MK, Abbas Z. Outcome of Reamed Intramedullary Interlocking Nail in Tibial Diaphyseal Fractures in Terms of Frequency of Union and Wound Infection. J Pak Orthop Assoc. 2015; 27(1): 01-4.
13. Nwadinigwe C, Ukibe S, Eke C, Ugorji T, Chikezie K. The epidemiology, management and complications of tibia fractures treated in major hospitals in Imo State, Southeast Nigeria. Afrimed J. 2022; 8(1): 12-6.
14. Reátiga Aguilar J, Rios X, González Edery E, De La Rosa A, Arzuza Ortega L. Epidemiological characterization of tibial plateau fractures. J Orthop Surg Res. 2022; 17(1):106.
15. Sagar BVS, Nandi SS, Kulkarni SR, Bagewadi R. Functional Outcomes of Tibia Fractures Treated With Intramedullary Interlocking Nails by Suprapatellar Approach: A Prospective Study. Cureus. 2023; 15(6): e40485.
16. Daolagupu AK, Mudgal A, Agarwala V, Dutta KK. A comparative study of intramedullary interlocking nailing and minimally invasive plate osteosynthesis in extra-articular distal tibial fractures. Indian J Orthop. 2017; 51(3): 292-8.
17. Bhandari M, Guyatt GH, Tornetta P, Swiontkowski MF, Hanson B, Sprague S et al. Current practice in the intramedullary nailing of tibial shaft fractures: an international survey. J Trauma. 2002; 53(4): 725-32.
18. Radaideh A, Alrawashdeh MA, Al Khateeb AH, Obeidat O, Tabar M, Essa SMB et al. Outcomes of Treating Tibial Shaft Fractures Using Intramedullary Nailing (IMN) versus Minimally Invasive Percutaneous Plate Osteosynthesis (MIPPO). Med Arch. 2022; 76(1): 55-61.
19. Turley L, Barry I, Sheehan E. Frequency of complications in intramedullary nailing of open tibial shaft fractures: a systematic review. EFORT Open Reviews. 2023; 8(2): 90-9.
20. Alsharef JF, Ghaddaf AA, AlQuhaibi MS, Shaheen EA, AboAljadiel LH, Alharbi AS et al. External fixation versus intramedullary nailing for the management of open tibial fracture: meta-analysis of randomized controlled trials. Int Orthop. 2023; 47(12): 3077-97.
21. Ali P, Jatoi F, Hussain M, Muhammad D, Matlo E, Khoso RE et al. Comparison of the Outcome of Intramedullary Nailing Versus External Fixator Fracture Repair in Gustilo Type IIIA Tibio-Fibular Fracture. Pak Armed Forces Med J. 2022; 72(4).
22. Roberts HJ, Donnelley CA, Haonga BT, Kramer E, Eliezer EN, Morshed S et al. Intramedullary nailing versus external fixation for open tibia fractures in Tanzania: a cost analysis. OTA Int. 2021; 4(3): e146.
23. Kashyap S, Ambade R, Landge S, Salwan A. Impact of Surgical Timing on Fracture Healing in Tibial Shaft Injuries: A Comparative Review of Intramedullary Nailing Techniques. Cureus. 2024; 16(10): e70978.
24. Javed H, Olanrewaju OA, Ansah Owusu F, Saleem A, Pavani P, Tariq H et al. Challenges and Solutions in Postoperative Complications: A Narrative Review in General Surgery. Cureus. 2023; 15(12): e50942.
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