OUTCOME EVALUATION OF UNREAMED CLOSED INTERLOCKING INTRA MEDULLARY NAILING IN THE MANAGEMENT OF OPEN TIBIAL SHAFT FRACTURES ACROSS GUSTILO ANDERSON TYPES EXCEPT TYPE IIIC
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Keywords
Unreamed, Closed Interlocking, Intramedullary Nailing, Open Tibial Shaft Fractures, Gustilo-Anderson Type, Type 111C
Abstract
Background: This study was conducted to evaluate the effectiveness of unreamed closed interlocking intramedullary nailing, with the exception of type IIIC, in the treatment of open tibial shaft fractures throughout the Gustilo-Anderson type.
Methods: This was a hospital-based study conducted among patients, both male and female who had open fractures of the tibia. The study was undertaken at the department of Orthopaedics, Basaveshwar Teaching and General Hospital, Gulbarga. 20 patients who had open fractures of the tibial shaft were treated with wound debridement and interlocking intramedullary nailing without reaming from January 2021 to December 2022 after obtaining clearance from the institutional ethics committee and written informed consent from the study participants.
Results: The majority of the patients belonged to the 25–31 age range. There are just three female patients out of the total 17 (85%) male patients. (15%). Road traffic accidents were the leading cause of fractures (75%). Most individuals had fractures to their right tibia. Fifteen patients (75%) had fractures to their right tibia. The majority of the open fractures of the tibia were Gustilo type I (50%). The majority of the fracture patterns (40%) were shared by 8 patients. Transverse was in 5 (25%), oblique was also 5 (25%) and spiral was 2 (10%). Most of the patients were operated on within 1 (i.e., 8-24 hours) after trauma (50%); 1 case was operated on less than 8 hours after trauma (5%), 18 cases were operated on under spinal anaesthesia and 2 cases under general anaesthesia. The midline patellar tendon splitting technique was applied for nail implantation in each case. We operated for an average of ninety minutes. (Time interval: 60–120 minutes) Outcomes for 15 instances (75%) were great, 3 cases (15%) had acceptable outcomes, 1 case (5%) was fair, and 1 case (5%) was bad. 14 patients (70%) were pleased, 5 patients (25%) were satisfied, and 1 patient (5%) was unhappy.
Conclusion: Early weight bearing and early joint mobility are important benefits of interlocking since they enable a quicker return to work. Unreamed interlocking nailing is a viable treatment option for open tibial shaft fractures that has demonstrated favourable outcomes with few problems.
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Dr. Alok C. Patil
Assistant Professor, Department of Orthopaedics, Mahadevappa Rampure Medical College Kalaburagi, Karnataka, India.
Dr. Bindusar
Senior Resident, Department of Orthopaedics, Kodagu Institute of Medical Sciences, Kodagu, Karnataka, India.
Dr. Shivaraj A. C.
Assistant Professor, Department of Orthopaedics, Mahadevappa Rampure Medical College Kalaburagi, Karnataka, India.
Dr. Shweta Patil
Consultant Neurologist, ESIC Medical College Kalaburagi, Karnataka, India.