CLINICAL AND RADIOLOGICAL OUTCOMES OF INTRAMEDULLARY NAILING IN TIBIAL SHAFT FRACTURES: A PROSPECTIVE STUDY
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Keywords
Tibial shaft fracture, Intramedullary nailing, Interlocking nail, Fracture union, Functional outcome, Radiological outcome, Orthopaedic trauma, Long-bone fractures.
Abstract
Tibial shaft fractures are among the most common long-bone fractures encountered in orthopedic practice and frequently result from high-energy trauma such as road traffic accidents, falls, and sports-related injuries. Due to the subcutaneous location and limited soft tissue coverage of the tibia, these fractures are often associated with complications including delayed union, non-union, malalignment, and infection. Intramedullary nailing (IMN) has become the preferred surgical treatment for most tibial shaft fractures because it provides stable fixation, preserves the fracture hematoma, allows early mobilization, and promotes fracture healing. However, continuous evaluation of clinical and radiological outcomes is necessary to optimize patient care and improve treatment protocols.
Objective:
To evaluate the clinical and radiological outcomes of intramedullary nailing in patients with tibial shaft fractures and to assess the incidence of postoperative complications.
Materials and Methods:
A prospective observational study was conducted among 100 patients with tibial shaft fractures treated with closed or open reduction and intramedullary interlocking nailing at a tertiary care teaching hospital. Patients aged 18–65 years with acute tibial shaft fractures were included. Clinical assessment was performed using pain scores, range of motion of the knee and ankle joints, time to full weight-bearing, and functional outcome scores. Radiological evaluation included assessment of fracture alignment, callus formation, and time to fracture union. Patients were followed up at regular intervals for a minimum period of 12 months. Data were analyzed using descriptive and inferential statistical methods.
Results:
The mean age of the patients was 36.8 ± 11.4 years, with males accounting for 72% of cases. Road traffic accidents were the most common mechanism of injury (65%). Radiological union was achieved in 92% of patients, with a mean union time of 18.6 ± 4.2 weeks. Excellent to good functional outcomes were observed in 88% of patients based on standardized functional assessment criteria. Full weight-bearing was achieved at a mean duration of 10.4 ± 2.8 weeks. Complications included anterior knee pain (12%), delayed union (8%), superficial infection (5%), malalignment (4%), and non-union (2%). Significant improvement in functional scores was observed during follow-up (p < 0.001).
Vol.56 No.15 (2016): JPTCP 80-89)
Conclusion:
Intramedullary interlocking nailing is an effective and reliable treatment modality for tibial shaft fractures, providing high union rates, satisfactory functional recovery, and acceptable complication rates. Early stabilization and mobilization associated with this technique contribute to favorable clinical and radiological outcomes. Intramedullary nailing should remain a preferred treatment option for appropriately selected tibial shaft fractures.
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Dr. Baidyanath Kumar
Assistant Professor, Department of Orthopaedics, Gouri Devi Institute of Medical Science & Hospital, Durgapur, WB, India
