scholarly journals Primary interlocking nailing for open fractures of tibial shaft: a clinical study

2019 ◽  
Vol 5 (5) ◽  
pp. 811
Author(s):  
Talluri V. G. Krishna
Keyword(s):  
Intramedullary Nailing ◽  
Open Fractures ◽  
Type I ◽  
Type Ii ◽  
Tibial Shaft ◽  
Non Union ◽  
Interlocking Nailing ◽  
Type Iiia ◽  
Open Injury ◽  
Closed Intramedullary Nailing

<p class="abstract"><strong>Background:</strong> The excellent method for treating fractures of the tibial shaft was the closed intramedullary nailing technique. But because of limited references related to the results, incidence of infection, non-union of open injury. Hence, it was decided to analyse open tibial fractures treatment by primary interlocking nailing.</p><p class="abstract"><strong>Methods:</strong> 50 Patients with open fractures of the tibial shaft which were treated with primary interlocking nail were studied in the period of 14 months.<strong></strong></p><p class="abstract"><strong>Results:</strong> In present study 18 (36%) type I, 22 (44%) type II and 10 (20%) type IIIA Gustilo open fractures were treated. The average duration of time between injury and nailing was 3.5 hours (range was 1.5 hours to 4 hours). After reaming, 40 (80%) fractures were fixed, without reaming, 10 (20%) of fractures were fixed. The average time to union was 27 weeks for type I fractures, 30 weeks for type II fractures and 33 weeks for type IIIA fractures. There was 1 non-union. There were 4 deep infections.</p><p class="abstract"><strong>Conclusions:</strong> The best mode of therapy was primary interlocking intramedullary nailing for open fractures.</p>

scholarly journals Comparitive Study of Reamed vs Unreamed Interlocking Intra Medullary Nailing for Fracture Shaft of Tibia

2021 ◽  
pp. 417-422
Author(s):  
N. Mathivanan ◽  
S. V. Satyanarayana
Keyword(s):  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Medullary Canal ◽  
Open Fractures ◽  
Tibial Shaft ◽  
Advantages And Disadvantages ◽  
Interlocking Nailing ◽  
Open Injury ◽  
Radiological Union

Tibia is the commonest bone to sustain open injury because of subcutaneous position. Treatment of open fractures requires simultaneous management of both skeletal and soft tissue injury. Intramedullary nailing with reaming is generally considered to be contraindicated for open fractures tibia, because it damages the endosteal blood supply which will lead to non-union, deep infection. However, recent studies with or without reaming in open fracture tibia shows no influence in healing of fracture. Purpose: To compare the clinical and radiological results of intramedullary interlocking nailing of open fractures of the tibial shaft after reaming versus unreamed medullary canal. The aim and objective is a comparative study on the technique, outcome and time taken for clinical and radiological union in either of the reamed or unreamed interlocking nailing in tibial shaft fractures. The operative technique, advantages and disadvantages, follow up, time taken for bony and radiological union and complications if any and overall functional outcome will be evaluated in patients. The follow up of patients will be done in the immediate post operative period and  subsequently  at periodic intervals both clinically and radiologically and the result so obtained will be compared.

Role of Reamed and Unreamed Interlocking Intermedullary Nailing in the Management of Compound Fracture of Shaft Tibia

2014 ◽  
Vol 23 (Number 2) ◽  
pp. 21-26
Author(s):  
Md. F Ahmed ◽  
Md. M Rahman ◽  
K Dipu ◽  
Md. N Islam
Keyword(s):  
Soft Tissue ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Deep Infection ◽  
Medullary Canal ◽  
Open Fractures ◽  
Soft Tissue Coverage ◽  
Non Union ◽  
Interlocking Nailing ◽  
Open Injury

Tibia is the commonest bones to sustain open injury because of subcutaneous position. Treatment of open fractures requires simultaneous management of both skeletal and soft tissue injury. Intramedullary nailing with reaming is generally considered to be contraindicated for open fractures tibia, because it damages the endosteal blood supply which will lead to non-union, deep infection. The study was done to compare the clinical and radiological results of intramedullary interlocking nailing of open fractures of the tibial shaft after reaming versus unreamed medullary canal. Open fractures of shaft of tibia treated with unreamed/reamed interlocking nailing gave excellent results. In present series, 19 fractures (95%) treated by unreamed and 19 (95%) fractures treated by reamed technique, united within 6 months of injury. Delay in union was noticed in one patient treated by unreamed technique who had segmental and extensive soft tissue injury and in reamed nailing there was one patient with deep infection, which was treated with antibiotic coated nail. Time to complete union was similar in both groups. Adequate debridement of wound and adequate soft tissue coverage is the key to minimize deep infection irrespective of whether the bone is reamed or not.

scholarly journals Evaluation of compound tibial fractures managed with an Ilizarov ring fixator

2020 ◽  
Vol 6 (4) ◽  
pp. 710
Author(s):  
Praveen Ravi ◽  
Muthumanickam Ramanujam ◽  
Jambu Nageswaran ◽  
Sundar Suriyakumar
Keyword(s):  
Open Fractures ◽  
Tibial Fractures ◽  
Long Bone ◽  
Type Ii ◽  
Ring Fixator ◽  
Type Iiia ◽  
Type Iiib ◽  
Ilizarov Ring Fixator ◽  
Ilizarov Fixator ◽  
The Ideal

<p class="abstract"><strong>Background:</strong> The tibia is the most commonly fractured long bone and because of its location and the tenuous soft tissue coverage, its more prone for open fractures tibia than any other long bone. The ideal management of such fractures still remains controversial. We have evaluated the healing of fractures and functional outcomes in patients with open tibial fractures treated with an Ilizarov ring fixator.</p><p class="abstract"><strong>Methods:</strong> 32 patients who had open fractures of the tibia (II, IIIA or IIIB) who were treated with an Ilizarov fixator were included in the study. The patients were followed up for a minimum period of 1 year after removal of the fixator. Functional and radiological results were analysed using association for the study of applications of methods of Ilizarov scoring.<strong></strong></p><p class="abstract"><strong>Results:</strong> There were 20 cases of type IIIB, 7 cases of type IIIA, 5 cases of type II fractures. Union was achieved in all patients. Mean time for union was 25.2 weeks, with faster union times in type II, type IIIA fractures. Six cases of type IIIB needed flap cover. Limb discrepancy was seen in 3 cases. 17 cases of pin tract infections were seen, most of which were grade 3 and were managed with antibiotics. Two cases had delayed union, of which one was treated with bone marrow aspirate injection and the other one with bone grafting. At one year, 21 (65.6%) had excellent results, six (18.7%) had good results, four (12.5%) had fair outcomes and one (3.2%) had a poor result.</p><p class="abstract"><strong>Conclusions:</strong> Despite the associated complications, Ilizarov fixator is the ideal treatment for compound tibial fractures.</p>

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