6 - The treatment of tibia diaphyseal fractures with locked intramedullary nailing; midterm results
Onat Üzümcügil, Ahmet Doğan, Merter Yalçınkaya, Mirza Zafer Dağtaş, Nikola Azar, Erhan Mumcuoğlu, Yavuz Selim Kabukçuoğlu
Objectives: The evaluation of the clinical and radiological midterm results of the patients with tibia diaphysis fractures treated by locked intramedullary nails.
Methods: 67 patients with tibia diaphysis fracture who were treated with locked intramedullary nail (45 male, 22 female; mean age 36,9; range 16 to 69) were included in the study. The fractures were on the right side in 42 patients and on the left side in 25 patients. The mean period between the operation and the onset of the fracture was 12 days (range 1-35 days) and the mean follow-up period was 46,5 months (range 6 to 123 months). The results were evaluated according to Johner-Wruhs criteria.
Results: In our study group, the average time to union was 21,1 weeks (median 18 weeks, range 6 to 36 weeks). According to the Johner-Wruhs criteria; of 67 patients, the results were excellent in 36 patients (53,7%), good in 17 patients (25,3%), fair in 7 patients (%10,5) and poor in 7 patients (10,5%). 14 patients (20,9%) with malalignment and 12 patients (17,9%) with restriction of adjacent joint motion were also reported.
Conclusion: Malalignment and the restriction of adjacent joint motion were found to be the two important factors responsible of the decrease in the clinical satisfaction rates. We believe that in order to fix those two factors; proper reduction of the fracture during the primery surgery, well-determination of the cases necessiating statical locking, much care taken about dinamisation and weight bearing times and an appropriate rehabilitation program are mandatory.
Keywords: Tibia, fracture, locked intramedullary nail, union
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