Online ISSN: 2515-8260

Keywords : Tibial fractures


REAMED INTRAMEDULLARY INTERLOCKING NAILS: A PREFERABLE OPTION FOR FIXING TIBIAL FRACTURES IN ADULTS

Biju Raveendran, Anvesh Gattu, A. Imadulla

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 2632-2641

Background: The frequently fractured long bone in the human anatomy is tibia and the mode of surgical procedure relays on evaluating the mode of injury, configuration of fracture and individual health and financial status. The use of non-operative treatment of tibial fractures is associated with a high prevalence of malunion, joint rigidity and deprived functional consequence. Tibial shaft fractures are recurrently treated by intramedullary interlocking nails. The necessity of opting reamed intramedullary nail is considered the gold standard implant for tibial fractures in closed and open (Gustilos) fractures.
Materials and Methods: The study consists of 52 patients with tibia shaft fracture treated with tibia interlocking nail. Clinical outcome and functional results were evaluated by Klemm and Borner criteria.
Results: In this study, we have operated a total 52 cases with tibia interlocking nail in tibial shaft fractures. The union rate in closed fracture was started earlier at 12.50 weeks in 80.76% (42) cases and it took 15.89 weeks in 13.46% in (7) cases and 19.50 weeks in 5.76% (3) cases for union in Type I and Type II fracture respectively. The study yielded about 92.30% (48 cases) of excellent result.
Conclusion: The present study shows that closed fractures of the tibia shaft treated with interlocking intramedullary tibia nailing involves minimal surgical trauma and negligible blood loss. It provides the advantages of early ambulation, lower rates of infection and non-union. A significant advantage of interlocking nail in addition to early joint mobilisation, is early weight bearing which allows earlier return to work. Hence the study concluded that closed interlocking intramedullary nail is the treatment of choice in closed tibia shaft fracture.

A prospective study of analysis of fasciocutaneous flaps at various stages of open tibial fractures

Dr.G.Praveen Harish, Dr.Nagaprasad.N, Dr.M.Madhusudhan Naik, Dr.Laxman. S

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 10329-10339

Introduction: Coverage of open tibial fractures presents unique defects requiring the
ingenuity of the surgeon in devising flaps for stable coverage. In our country road
traffic accidents are the most common cause of lower limb trauma, followed by fall
from height. Though well established norms are in place regarding the time and nature
of cover, it requires a team effort with involvement of the orthopaedic surgeon as a rule,
and allied specialities like plastic surgeons, general surgeons
Aims: To analyzefasciocutaneous flaps reliability in coverage of open tibial fractures
Materials and methods: This study was conducted in the Department of Plastic and
reconstructive Surgery, Osmania General Hospital, Hyderabad over a period of 24
months from DEC 2019 to DEC 2021. 50 cases age group 10-60yrs of both genders who
present with open tibial fractures that are covered with fasciocutaneous flaps, small to
medium sized tissue defects of leg. Timing of coverage was classified into Acute- within
72 hours, Subacute- 3 days to 6 weeks, Chronic- Greater than 6 weeks. All the patients
included in the study were admitted to the trauma ward under the care of the attending
orthopedician and received first aid.They were then resuscitated to minimize bleeding,
restore airway and correct shock.
Results: The overall incidence of complications in this series of fasciocutaneous flaps
was 42%. Distally based fasciocutaneous flaps had a higher complication rate. major
complications, usually a failure of the intended coverage, actually more common for
proximally based flaps (12.9%) than those distally based (6.3%),although not stastically
different(p=0.436). Infection was the most common complication - 16% of all
complications. Total flap loss was seen in only 2 patients which indicated a successful
wound coverage in 96%.
Conclusion: Flap coverage is best done within 72 hours of injury. Overall early surgery
significantly reduces patient’s morbidity, decreased hospital stay and early return to
work.