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International Journal of Orthopaedics Sciences 2021; 7(2): 417-422
E-ISSN: 2395-1958
P-ISSN: 2706-6630
IJOS 2021; 7(2): 417-422
© 2021 IJOS
www.orthopaper.com
Received: 04-02-2021
Accepted: 08-03-2021
Dr. Veeresh Mahantesh Wali
Junior Resident, Department of
Orthopaedics, Adichunchanagiri
Insititute of Medical Sciences
B G Nagara, Mandya,
Karnataka, India
Dr. Harish K
Associate Professor,
Department of Orthopaedics,
Adichunchanagiri Insititute of
Medical Sciences B G Nagara,
Mandya, Karnataka
Dr. Abdul Ravoof
Professor, Department of
Orthopaedics Adichunchanagiri
Institute of Medical Sciences,
B G Nagara, Mandya,
Karnataka, India
Dr. BG Sagar
Professor and Head of
Department, Department of
Orthopaedics, Adichunchanagiri
Insititute of Medical Sciences
B G Nagara, Mandya,
Karnataka, India
Corresponding Author:
Dr. Abdul Ravoof
Professor, Department of
Orthopaedics Adichunchanagiri
Institute of Medical Sciences,
B G Nagara, Mandya,
Karnataka, India
Surgical management of compound fracture tibia using
an unreamed interlocking intramedullary nail
Dr. Veeresh Mahantesh Wali, Dr. Harish K, Dr. Abdul Ravoof and Dr. BG
Sagar
DOI: https://doi.org/10.22271/ortho.2021.v7.i2f.2657
Abstract
Background and Objectives: Tibial fractures are one of the most common long bone fractures with
increasing number of motor vehicle accidents. Complications like compartment syndrome, neurovascular
injuries, malunion are common. Reaming before insertion of nail disrupts the medullary blood supply.
Infection rate with reaming is high because the foreign bodies, dust, etc are pushed deeper into the tissues
with reaming. Thus considering all these factors, the unreamed intramedullary nail can be used for the
management of compound fractures of tibia.
Materials and methods: The present study was conducted at the Department of Orthopedics,
Adichunchangiri Institute of Medical Sciences, B G Nagara, Mandya district after obtaining ethical
clearance. This study was conducted on 20 patients involving both male and female. Study was
conducted for a period of 18 months from December 2018 to June 2020. Cases were followed up with 4
visits.
Results: Compound fractures of the tibia treated by unreamed interlocking intra medullary nail gave
excellent results measured by surgical outcome and patient satisfaction. This technique boasts lower rates
of complications in comparison with other treatment modalities.
Interpretation & Conclusion: Unreamed interlocking nailing is a lucrative option in management of
compound and segmental tibial fractures. It promotes early union. Also it has low risk of infection. Early
mobilisation can be advocated. It helps early return to activities.
Keywords: Unreamed, interlocking intramedullary nailing, dynamisation, reaming
Introduction
“The primary objective in the management of an open fracture is union with prevention or
eradication of wound sepsis.” - Gustillo et al. It is a well known fact that tibia is the most
commonly fractured long bone. There are 26 cases of tibia fractures per lakh population.
Because of its very location: compound fractures in tibia are common because two third of
tibia is subcutaneous distal tibia has less muscle coverage because of which there is less
protection and poor blood supply which may even result in non union later. Complications like
compartment syndrome, infection, non union are common. Knee joint and ankle joint give
very less freedom of movement for leg. Usually tibia gets fractured in five ways; direct blow,
assaults, sports falls and injuries, falls, road traffic accidents and bullet injuries
[1]
. With use of
C-arm, use of intramedullary nail is favourable and an attractive option. Nail is a load sharing
device. It shows resistance to both axial and torsional forces. Locking of the nail proximally
and distally gives rotational and axial stability. Reaming before insertion of nail disrupts the
medullary blood supply. Nailing with reaming provides a double insult to the nutrient artery
distribution
[2]
. Infection rate with reaming is high because the foreign bodies, dust, etc are
pushed deeper into the tissues with reaming.
Materials and Methods
The present study was conducted at the department of Orthopedics, Adichunchangiri institute
of medical science, B G Nagara, Bellur, Mandya district after obtaining ethical clearance. This
study was conducted on 20 patients involving both male and female. Study was conducted for
a period of 18 months from December 2018 to June 2020.