Osteosynthesis distal tibial metadiaphyseal fractures with intramedullary nailing versus plating

Deepak Vashisht; Manjit S. Daroch; Sanjeev Sreen; Kuldeep Rathi

doi:10.18203/2320-6012.ijrms20171851

Osteosynthesis distal tibial metadiaphyseal fractures with intramedullary nailing versus plating

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20171851 ◽

2017 ◽

Vol 5 (5) ◽

pp. 2104

Author(s):

Deepak Vashisht ◽

Manjit S. Daroch ◽

Sanjeev Sreen ◽

Kuldeep Rathi

Keyword(s):

Intramedullary Nailing ◽

Weight Bearing ◽

Operating Time ◽

Distal Tibia ◽

Full Weight Bearing ◽

P Value ◽

Operative Care ◽

Diaphyseal Fractures ◽

Time Required ◽

Early Restoration

Background: The management of the tibial fracture remains controversial despite advances in both non-operative and operative care. Plates and intramedullary nails are two well-accepted and effective methods, but each has been historically related to complications. The present study was conducted to compare the results of displaced extra-articular distal tibia meta-diaphyseal fractures OTA/AO Type 42A- C (distal) and 43-A treated with intramedullary nailing versus plating with respect to union of fracture, early Restoration of function, the axial alignment and Complications, if any.Methods: In this study 30 patients of extra-articular distal tibia fracture AO type 42 A-C (distal) and 43 A were randomly selected and 15 were operated with intramedullary nailing and remaining 15 with plating. The patients were regularly followed up for a period of 9 months with radiological and clinical examination. Final assessment was done by Tenny and Wiss clinical assessment criteria.Results: In Interlocking group, average time for union was 20.33 weeks in Interlocking nail group compared to 23.21 weeks in plating group which was significant (p value 0.011). Also, the average time required for partial and full weight bearing in the nailing group was 7.2 weeks and 13.2 weeks respectively which was significantly less as compared to 9.33 weeks and 16.64 weeks in the plating group. Lesser complications in terms of implant irritation, ankle stiffness and infection (superficial and deep) were seen in Interlocking group as compared to plating group.Conclusions: In present study ILN showed better outcome as it offers advantage in terms of mean operating time, less invasive surgery, hospital stay, partial and full weight bearing time and union time.

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Distal Tibia Metaphyseal Fractures: Which is Better, Intra-medullary Nailing or Minimally Invasive Plate Osteosynthesis?

Journal of Orthopaedics Trauma and Rehabilitation ◽

10.1016/j.jotr.2017.09.004 ◽

2018 ◽

Vol 24 (1) ◽

pp. 66-71

Author(s):

Kawalkar Abhijit Chandrakant ◽

Badole Chandrashekher Martand

Keyword(s):

Intramedullary Nailing ◽

Weight Bearing ◽

Distal Tibia ◽

Tibial Fractures ◽

Minimally Invasive Plate Osteosynthesis ◽

Early Weight Bearing ◽

Significant Difference ◽

Duration Of Surgery ◽

Tibia Fractures ◽

Distal Tibia Fractures

Introduction Tibia fractures are the most common long bone fractures encountered by the orthopedic surgeons and distal tibia fractures have the second highest incidence of all tibia fractures after the middle third of tibia the distal tibial fractures are unique and are considered as most challenging fractures to treat due to its proximity to the ankle joint and its superficial nature. The objective of this study is to compare two osteosynthesis systems developed for surgical treatment of distal tibia fractures: the intramedullary nailing and the MIPPO technique. Methods The study was conducted between Jan 2011 to Dec 2012. 63 patients with extra-articular distal tibia fracture treated with intramedullary nailing and MIPPO technique were reviewed retrospectively and clinical outcome was evaluated according to American Orthopaedic Foot and Ankle Score. Results 31 patients were treated with intramedullary nail & 32 with MIPPO technique. Fibular fixation was done in cases where fibular fracture was at or below the level of tibial fractures. We found no difference in terms of time for fracture union, mal-union, non-union, duration of surgery and amount of blood loss. But there was significant difference in terms of infection and duration of hospital stay. Also weight bearing was possible much earlier in intramedullary group as compared to the MIPPO group. Conclusion Thus we conclude that intramedullary nailing is better choice of implant in patients with extra- articular distal tibia fractures & helps in early weight bearing and ambulation of patient with fewer complications.

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Review of Variability in Rehabilitation Protocols after Lateral Ankle Ligament Surgery

Kansas Journal of Medicine ◽

10.17161/kjm.v13i.13820 ◽

2020 ◽

Vol 13 ◽

pp. 152-159 ◽

Cited By ~ 1

Author(s):

Christina Hermanns ◽

Reed Coda ◽

Sana Cheema ◽

Matthew Vopat ◽

Megan Bechtold ◽

...

Keyword(s):

Weight Bearing ◽

Return To Sport ◽

Full Weight Bearing ◽

Ligament Repair ◽

Lateral Ankle ◽

Operative Care ◽

Ankle Ligament ◽

Rehabilitation Protocols ◽

Lateral Ankle Ligament ◽

Suture Tape

Introduction. Ankle sprains are one of the most common athletic injuries. If a patient fails to improve through conservative management, surgery is an option to restore ankle stability. The purpose of this study was to analyze and assess the variability across different rehabilitation protocols for patients undergoing either lateral ankle ligament repair, reconstruction, and suture tape augmentation. Methods. Using a web-based search for published rehabilitation protocols after lateral ankle ligament repair, reconstruction, and suture tape augmentation, a total of 26 protocols were found. Inclusion criteria were protocols for post-operative care after an ankle ligament surgery (repair, reconstruction, or suture tape augmentation). Protocols for multi-ligament surgeries and non-operative care were excluded. A scoring rubric was created to analyze different inclusion, exclusion, and timing of protocols such as weight-bearing, range of motion (ROM), immobilization with brace, single leg exercises, return to running, and return to sport (RTS). Protocols inclusion of different recommendations was recorded along with the time frame that activities were suggested in each protocol. Results. Twenty-six protocols were analyzed. There was variability across rehabilitation protocols for lateral ankle ligament operative patients especially in the type of immobilizing brace, time to partial and full weigh bearing, time to plantar flexion, dorsiflexion, eversion and inversion movements of the ankle, and return to single leg exercise and running. For repair and reconstruction, none of these categories had greater than 60% agreement between protocols. All (12/12) repair, internal brace, and unspecified protocols and 86% (12/14) of reconstruction protocols recommended no ROM immediately postoperatively. Eighty-six percent (6/7) of repair and 78% (11/14) of reconstruction protocols recommended no weight-bearing immediately after surgery, making post-operative ROM and weight-bearing status the most consistent aspects across protocols. Five protocols allowed post-operative weight-bearing in a cast to keep ROM restricted. Sixty-six percent (2/3) of suture tape augmentation protocols allowed full weight-bearing immediately post-operatively. Suture tape augmentation protocols generally allowed rehabilitation to occur on a quicker time-line with full weight-bearing by week 4-6 in 100% (3/3) of protocols and full ROM by week 8-10 in 66% (2/3) protocols. RTS was consistent in repair protocols (100% at week 12-16) but varied more in reconstruction. Conclusion. There is significant variability in the post-operative protocols after surgery for ankle instability. ROM was highly variable across protocols and did not always match-up with supporting literature for early mobilization of the ankle. Return to sport was most likely to correlate between protocols and the literature. Weight-bearing was consistent between most protocols but requires further research to determine the best practice. Overall, the variability between programs demonstrated the need for standardization of rehabilitation protocols.

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Comparison of intramedullary nailing fixation and percutaneous locked plating fixation for the treatment of proximal tibial fractures: A meta-analysis

Journal of Orthopaedic Surgery ◽

10.1177/23094990211024395 ◽

2021 ◽

Vol 29 (2) ◽

pp. 230949902110243

Author(s):

Cheng Ren ◽

Ming Li ◽

Liang Sun ◽

Zhong Li ◽

Yibo Xu ◽

...

Keyword(s):

Intramedullary Nailing ◽

Meta Analysis ◽

Weight Bearing ◽

Tibial Fractures ◽

Fixation Method ◽

Cochrane Library ◽

Full Weight Bearing ◽

Locked Plating ◽

Fixation Group ◽

Proximal Tibial Fractures

Objective: This meta-analysis aimed to systematically compare the clinical outcomes of intramedullary nailing (IMN) fixation and percutaneous locked plating (PLP) fixation in the treatment of proximal tibial fractures. Methods: We searched PubMed, Embase, Cochrane library, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), and Wan Fang to select relevant articles up to March 29, 2020 without language limit. Continuous variables were estimated by weighted mean difference (WMD) with a 95% confidence interval (CI) and dichotomous outcomes were calculated by relative risk (RR) with 95% CI. Moreover, heterogeneity analysis was evaluated. Furthermore, publication bias assessment and sensitivity analysis were conducted. Stata 11.0 software was used to perform the statistical analysis. Results: Ten studies involving 667 cases (321 from IMN fixation group and 346 from PLP fixation group) were included. The type of fractures involved in the included articles was extra-articular proximal tibia fractures. IMN fixation method achieved significantly shorter union time ( WMD = −2.88, 95% CI: −3.23 to −2.53, p < 0.001) and full weight-bearing time ( WMD = −2.81, 95% CI: −3.64 to −1.97, p < 0.001) than PLP fixation method. Meanwhile, IMN fixation resulted in lower risks of infection ( RR = 0.50, 95% CI: 0.27 to 0.91, p = 0.02) and total complications ( RR = 0.36, 95% CI: 0.22 to 0.60, p < 0.001) than PLP fixation. No significant differences were found in the incidence of nonunion ( p = 0.33), malunion ( p = 0.38), and osteofascial compartment syndrome (OCS, p = 0.62) between the two groups. Conclusions: Compared to PLP fixation, IMN fixation had several advantages in treating proximal tibial fractures, including the short time of union and full weight-bearing, as well as a low risk of infection and total complications.

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TREATMENT OF TALAR BODY FRACTURES WITH CLOSED REDUCTION AND PERCUTANEOUS FIXATION AT ORTHOPAEDICS DEPARTMENT OF DMCH, LAHERIASARAI, BIHAR

10.36106/ijsr/0527242 ◽

2020 ◽

pp. 1-3

Author(s):

Ramashish Yadav ◽

Ramsagar Pandit ◽

Nand Kumar ◽

Debarshi Jana

Keyword(s):

Closed Reduction ◽

Weight Bearing ◽

Distal Tibia ◽

Functional Results ◽

The Body ◽

Radiographic Evaluation ◽

Full Weight Bearing ◽

Medial Malleolus ◽

Percutaneous Fixation ◽

Medial Malleolus Fracture

Background: Fractures of the talus have a relatively low incidence accounting for 0.3% of all bone fracturesand 3–6% of all foot fractures. These injuries affect the neck of the talus, more than the head or the body. Talar body fractures of the talus are uncommon accounting for 7–38% of all talus fractures. Patients and Methods: Fifteen patients with fracture of the talus were operated on using closed reductionand percutaneous screws fixation. The patients (Table 1) were followed up for an average of 20 months (range 12-30 months). In 12 patients the talar fracture was an isolated fracture of the talus in the foot and ankle region. Patient no. 2 had ipsilateral fractures of the distal tibia, fibula, and calcaneus. Patient no. 7 suffered from ipsilateral fracture of the fifth metatarsal. Patient 4 had ipsilateral medial malleolus fracture. Results: Radiographic evaluation postoperative showed exact reduction in all cases but three which had astep of 2mm and 1.5 mm displacement. There were no re-displacements of the fractures, and all patients achieved union radiologically and clinically and could walk without external aid with full weight bearing by third to sixth month postoperative. Functional results according to Hawkins were excellent in five patients, good in seven, fair in three, and no poor results. Conclusion: Closed reduction and percutaneous fixation of talar body fractures is a good technique withaccepted clinical and radiological results, and less complications

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The circular arc internal fixation for tibio-talo-calcaneal arthrodesis

Foot & Ankle Orthopaedics ◽

10.1177/2473011418s00295 ◽

2018 ◽

Vol 3 (3) ◽

pp. 2473011418S0029

Author(s):

Kaj Klaue

Keyword(s):

Sagittal Plane ◽

Weight Bearing ◽

Distal Tibia ◽

Vertical Plane ◽

Neurological Complications ◽

Full Weight Bearing ◽

Circular Arc ◽

Full Contact ◽

Heel Contact ◽

Anatomical Alignment

Category: Hindfoot Introduction/Purpose: Stabilizing a tibio-talo-calcaneal arthrodesis in anatomical alignment allowing for weight bearing is a technical challenge. Normal anatomy demonstrates alignment of the heel, the posterior subtalar facet, the talus, the ankle joint and the distal tibia on a circular arc. This arc lies on a vertical plane which is slightly angulated inwards in relation to the sagittal plane. Today’s hindfoot nails do not respect this alignment. Complications include malalignment, primary instability, plantar neuropraxia. Purpose of the study is to optimize the technique to stabilize the hindfoot in anatomical alignment. Methods: An instrumentation was designed to create a circular arc bore hole crossing the heel, the posterior subtalar facet, the tibio-talar joint and the distal tibia metaphysis. At the operation, the desired definitive position of the hindfoot is fixed temporarily with Kirschner wires. A guiding frame is fixed to three critical spots of the hindfoot to drill the central hole. Using an image amplifier the hole is bored using a motor driven end cutting flexible reamer which is seated within a rigid curved hull. The nail has the same shape than the hull and is impacted up to the distal tibia. The nail allows for eventual secondary impaction without losing full contact with the surrounding bone. 30 patients have been treated so far using this technique and evaluated more than 6 months post-operatively. Results: The pathology of the operated patients include post-traumatic, congenital and metabolic (diabetes) conditions. The mean follow-up is 16 months. We did observe 3 ruptures of the tibial locking screw which allowed for more spontaneous impaction. All cases went to consolidation without malunion or other complications. One diabetic patient developed a stable pseudarthrosis at the midfoot joints. The patients were treated for 2 weeks post-op with a closed circular cast allowing heel contact to the floor. After 2 weeks our patients did practise partial to full weight bearing using a cam walker for other 6 weeks. Conclusion: The tibio-talo-calcaneal arthrodesis can be successfully treated using a central circular arc shaped nail allowing for full form fit between implant and bone. The anatomical bony alignment of the hindfoot is corrected or preserved. Due to the safe and limited approaches, the technique prevents complications such as neurological complications and non-unions. We expect a shorter period of time between surgical fixation and full weight bearing.

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Comparative efficacy and safety profile for the treatment of humeral bone cysts in children: curettage and mixed bone grafting either with or without elastic intramedullary nailing

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-02130-6 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Xuan Wang ◽

Jiuhui Han ◽

Yazhou Li ◽

Yuchang Liu ◽

Junzhong Luo

Keyword(s):

Intramedullary Nailing ◽

Safety Profile ◽

Bone Grafting ◽

Weight Bearing ◽

Bone Cyst ◽

Operation Time ◽

Full Weight Bearing ◽

Control Group ◽

Pain Level ◽

Elastic Intramedullary Nailing

Abstract Purpose The primary aim of our study was to evaluate the comparative efficacy and safety profile of curettage and mixed bone grafting without instrument or with elastic intramedullary nailing in the treatment of humeral bone cyst in children. Methods Our retrospective study included a total of 48 children harboring humeral bone cyst in our hospital from August 2012 to February 2019. The patients enrolled were divided into elastic nailing group with the application of elastic intramedullary nailing (n = 25) and control group without using instrument (n = 23) during the management of curettage and mixed bone grafting. The following medical outcomes of the two groups were monitored and recorded: the amount of intraoperative blood loss, operation time and postoperative full weight-bearing time, in addition to postoperative clinical effects after 1 year, the function and pain level of shoulder joint before and 1, 3, 6, 9, 12, and 16 months after operation. Follow-up radiographic outcomes were reviewed to observe bone healing, local recurrence and internal fixation loosening, and other postoperative complications. Results The clinical curative effect of the elastic nailing group was higher than that of the control group 16 months after operation (96.00% > 73.91%, P < 0.05). The intraoperative blood loss and postoperative full weight-bearing time in the elastic nailing group were less than those in the control group (P < 0.05), but the operation time was statistically insignificant between the two groups (P > 0.05). Before operation, the shoulder joint function of the two groups was comparable (P > 0.05), while the function showed remarkably better outcome in the elastic nailing group than control group 1 to 16 months after operation (P < 0.05). Before operation, the pain level of the two groups was comparable (P > 0.05), while 1 to 16 months after operation, the pain level of the elastic nailing group was significantly lower than that of the control group (P < 0.05). Patients in both groups were followed up for 16 months. Mixed bone grafting fusion was indicated by imaging CT and X-ray during the follow-up period, with an average fusion time of 11.3 ± 1.2 months (range, 8–16 months). Three months after operation, there was 1 case of incomplete pathological fracture in the control group, while no related complications occurred in the elastic nailing group. Moreover, no tumor recurrence was observed in the two groups. The two groups were comparable in terms of the incidence of complications (P > 0.05). Conclusion Children with humeral cyst treated with curettage and mixed bone grafting with the additional use of elastic intramedullary nailing exerted superior results to those without using instrument as there are beneficial outcomes and safety profile and no complications.

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Functional outcome of elastic stable intramedullary nailing of diaphyseal fractures of paediatric long bones

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20164169 ◽

2016 ◽

Vol 2 (4) ◽

pp. 359

Author(s):

Arun Vashisht ◽

Gaurav Dev Sharma

Keyword(s):

Conservative Treatment ◽

Functional Outcome ◽

Intramedullary Nailing ◽

Weight Bearing ◽

Elastic Stable Intramedullary Nailing ◽

Personal Hygiene ◽

Long Bones ◽

Forearm Bones ◽

Diaphyseal Fractures ◽

Partial Weight

Background: After the advent of titanium elastic nails (TENs) and gratifying results of elastic stable intramedullary nailing (ESIN) in diaphyseal fractures of paediatric long bones, not only the parents of patients are opting surgical treatment over conservative, but also more and more orthopaedicians are offering ESIN with TENs to obviate the inherent problems of conservative treatment. We took up this study to evaluate the functional outcome of ESIN with TENs.Methods: 44 patients aged 5-15 years suffering from diaphyseal fractures of femur, tibia, humerus, and forearm bones were treated by ESIN with TENs.Results: All 44 patients showed uneventful union, femur in an average period of 8.3 weeks, tibia in 7.3 weeks, forearm bones within 7 weeks and humerus in 7.5 weeks. Commonest complication was pain at insertion site. 1 femur patient had lengthening of 1.5 cm. 1 femur and 1 forearm patient showed joint stiffness. No patient had delayed/non-union, sagittal/coronal/rotational mal-union, and deep infection. Partial weight bearing (PWB) started from 2nd/3rd day attaining full weight bearing (FWB) in 6-10 weeks. Conclusions: ESIN with TENs appears logical and safe to obviate the inherent problems of conservative treatment, as ESIN is least invasive and allows early PWB/FWB leading to early independence of personal hygiene/toilet use with early social integration/return to school.

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A RANDOMIZED INTERVENTIONAL STUDY ON EFFECT OF CHEWING GUM ON RECOVERY OF GASTROINTESTINAL FUNCTIONS IN POSTOPERATIVE PATIENTS FOLLOWING ABDOMINAL SURGERIES IN THE DEPARTMENT OF OBSTETRICS AND GYNECOLOGY, SMS MEDICAL COLLEGE, JAIPUR

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i12.2325 ◽

2021 ◽

Vol 5 (12) ◽

Author(s):

Uravashi Suhana ◽

Megha Agrawal ◽

Krishan Kant

Keyword(s):

Operating Time ◽

Chewing Gum ◽

Control Group ◽

P Value ◽

Bowel Sound ◽

Gastrointestinal Dysfunction ◽

Medical College ◽

Operative Care ◽

Group Control Group ◽

Prolonged Hospital

Background: Post- operative gastrointestinal dysfunction is one of the complications following abdominal surgery which results in delayed return of bowel motility. It causes discomfort, prolonged hospital stay; hospital acquired infection and enhanced treatment cost. This study was conducted with an aim to analyze the clinical outcome of effect of chewing gum mainly to avoid post-operative gastrointestinal dysfunction and to compare the different gastrointestinal variables between cases and control group. Methods: In this study 80 patients were included, 40 Cases and 40. The cases were given chewing gum for duration of 15 minutes at 2nd , 4th and 6thhour of surgery. Bowel sound was auscultated at 3rd, 5th and 7th hour of surgery and outcomes were compared with control group. Control group were given only standard post-operative care. Results: Among cases Mean duration of 1st bowel sound appeared was 9.23±2.2 hours whie among control group was 15.99±3.48 hours and with operating time <1 hour is 5.1 ± 1.04 hours in cases and 6.2 ± .66 hours in control group while with operating time >1 hour it was 5.2 ± 1.03 hours cases and 6.3 ± 0.7 hours in control group. Mean duration of 1st flatus passed among cases was 13.3±2.24 hours while among control group was 26.62 ±2.6 hours and with operating time <1 hour was 13.8 ± 1.03 hours in cases and 16.25 ± 1.5 hours in control group, while it was 13.12 ± 1.96 hours in cases and 17.12 ± 1.5 hours in control group with operating time >1 hour. Mean duration of 1st motion passed among cases was 31.33±2.24 hours and was 44.62± 2.6 hours in control group and it was 48.8 ± 1.2 hours in cases and 50.7 ± 1.27 hours in control group with operating time <1 hour, while it was 48.8 ± 1.2 hours in cases and 51.1 ± 1.46 hours in control group with operating time >1 hour. Result was statistically significant P value (0.001).

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Comparative Study between Intra-medullary Nailing and Minimally Invasive Plate Osteosynthesis (MIPO) in Closed Distal Tibia Fracture in a District Hospital in Bangladesh

Journal of Shaheed Suhrawardy Medical College ◽

10.3329/jssmc.v12i1.51616 ◽

2021 ◽

Vol 12 (1) ◽

pp. 33-37

Author(s):

Md Asjadur Rahman ◽

Md Shahidullah Kaiser ◽

SM Roknuzzaman ◽

Nadim Ahmed

Keyword(s):

Intramedullary Nailing ◽

Weight Bearing ◽

Distal Tibia ◽

Tibia Fracture ◽

Tibial Fractures ◽

Distal Tibia Fracture ◽

Significant Difference ◽

Duration Of Surgery ◽

Tibia Fractures ◽

Distal Tibia Fractures

Introduction: Tibia fractures are the most common long bone fractures encountered by the orthopedic surgeons and distal tibia fractures have the second highest incidence of all tibia fractures after the middle third of tibia the distal tibial fractures are unique and are considered as most challenging fractures to treat due to its proximity to the ankle joint and its superficial nature. The objective of this study is to compare two osteosynthesis systems developed for surgical treatment of distal tibia fractures: the intramedullary nailing and the MIPO technique. Methods: The study was conducted between Jan 2018 to Dec 2019. 30 patients with extraarticular distal tibia fracture treated with intramedullary nailing and MIPO technique were reviewed retrospectively and clinical outcome was evaluated according to American Orthopaedic Foot and Ankle Score. Results: 15 patients were treated with intramedullary nail and 15 with MIPO technique. Fibular fixation was done in cases where fibular fracture was at or below the level of tibial fractures. We found no difference in terms of time for fracture union, mal-union, non-union, duration of surgery and amount of blood loss. But there was significant difference in terms of infection and duration of hospital stay. Also weight bearing was possible much earlier in intramedullary group as compared to the MIPO group. Conclusion: Thus we conclude that intramedullary nailing is better choice of implant in patients with extra- articular distal tibia fractures and helps in early weight bearing and ambulation of patient with fewer complications. J Shaheed Suhrawardy Med Coll, December 2020, Vol.12(1); 33-37

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Role of tibia interlocking nail in treating distal tibial metadiaphyseal fractures: study of 46 cases

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20175652 ◽

2017 ◽

Vol 4 (1) ◽

pp. 65

Author(s):

Neetin P. Mahajan ◽

Eknath D. Pawar ◽

Amit C. Supe ◽

Hitesh J. Mangukiya

Keyword(s):

Storage System ◽

Distal Tibia ◽

Delayed Union ◽

P Value ◽

Non Union ◽

Interlocking Nail ◽

Screw Breakage ◽

Diaphyseal Fractures

Background: Distal tibial diaphyseal fractures are known for its various challenges that orthopaedicians face while treating. While performing surgery, many principles of fixations are needed to be properly addressed. This study was undertaken to know the efficiency of closed reduction, polar screws and tibia interlocking nail fixation at our Institute.Methods: The data, which were collected from the medical records and Department digitalised storage system and from the HMIS patient filing system, included age, sex, date of admission, type of admission (elective versus emergency), and AO classification of distal tibial fracture admitted in Orthopaedics Department from 2007 to 2013. Analyses of 46 cases, 34 males and 12 females, were made to find out the functional, radiological outcome, associated complications in treating distal tibia with ILN. During Analysis, association of the single event with the variables was estimated using Relative Risk, with a 95% confidence interval and P value of <0.05 was considered significant.Results: The average time to union of the closed fracture was 15.4 weeks (range: 12–28 weeks). The healing times for the primarily nailed compound Grade I averaged 17.8 weeks (range: 15-34 weeks). Complications of delayed union occurred in 3 cases, and two cases of non-union. Infection in 6 cases (5 superficial, 1 deep), screw breakage in 4 cases and 3 cases of significant malalignment. The final functional outcome of 33 patients had excellent results, 11 had good results and 2 had fair results as determined by criteria of Johner and Wruh. Conclusions: The dynamic osteosynthesis of distal tibia by interlocking nail and judicious use of poller screws is an effective alternative for the treatment of distal metaphyseal tibial fractures.

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