are placed at frst followed by distal interlocking screw. Mechanism
of injury, age, sex, union time, foot function index, secondary
procedure, complications, deformities are analyzed in the study.
RESULTS: All patients were retrospectively analyzed. We could not
find any significant relation between post operative malalignment
and better foot function index (p = 0.975). Early union may not
improve overall foot function index (p = 0.202). Automobile accident
is the commonest mode of injury (48.5%) followed by automobile
pediastrian (39.4%). Postoperative malalignment consist of cornal
(3%), saggital (3%) and shortening (3%). Infection is one of the
commonest complication found in our study (6.1%).
Key words: Intramedullary nail; Proximal locking; Alignment
© 2018 The Author(s). Published by ACT Publishing Group Ltd. All
rights reserved.
Baral R, Kandel PR, Singh GP, Shrestha KM, Shrestha B, Panthi S.
Intramedullary Interlocking Nail in Distal One Third Tibia Fracture:
A Retrospective Study in Tertiary Care Center. International Journal
of Orthopaedics 2018; 5(3): 928-931 Available from: URL: http://
www.ghrnet.org/index.php/ijo/article/view/2305
INTRODUCTION
Distal tibia fracture is one of the challenging fractures presented in
the emergency department. The goal of the treatment is to provide
stable fxation with minimal soft tissue injury. Various methods are
involved in the treatment of this fracture Casting, nailing, plating,
external fxator are well known methods of treatment. Plates can be
inserted via open reduction internal fxation and minimally invasive
technique. The open technique provides stability but requires
extensive dissection. Minimally invasive plate technique may have
a complication of hardware problem
[1]
. External fxator is associated
with ankle stiffness
[2]
. Intramedullary nailing is one of the popular
method of treatment of distal one third tibia fracture but it is not
devoid of postoperative complication if not done properly
[3]
. It is
technically demanding procedure and its role in the treatment of
distal metaphyseal fractures has not been well defned
[4]
.
It is difficult to reduce and hold fracture perfectly during free
Rajiv Baral, Prakriti Raj Kandel, GP Singh, Kishor Man Shres-
tha, Bipan Shrestha, Sagar Panthi, Department of Orthopedic,
Universal College of Medical Sciences, Bhairahawa, Nepal
Confict-of-interest statement: The author(s) declare(s) that there
is no confict of interest regarding the publication of this paper.
Open-Access: This article is an open-access article which was
selected by an in-house editor and fully peer-reviewed by external
reviewers. It is distributed in accordance with the Creative Com-
mons Attribution Non Commercial (CC BY-NC 4.0) license, which
permits others to distribute, remix, adapt, build upon this work non-
commercially, and license their derivative works on different terms,
provided the original work is properly cited and the use is non-
commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Rajiv Baral, Universal College of Medical
Sciences, Bhairahawa, Nepal.
Email: rajibaral66@gmail.com
Telephone: +9779846036756
Received: April 2, 2018
Revised: May 20, 2018
Accepted: May 22 2018
Published online: June 28, 2018
ABSTRACT
AIM: To assess functional outcome of intramedullary interlocking
nail in distal tibia fracture where distal locking screw is applied after
inserting proximal locking screw.
PATIENTS AND METHOD: This is a retrospective study which
was conducted in Universal college of medical sciences. This study
was started one year back and last case was followed for one year.
All thirty three cases with distal tibia extraarticular fracture 42A1
and 43A3, according to AO classification, within 7 cm from the
ankle plafond of skeletally mature person presented in emergency
along with Gustillo Anderson (GA) I, II, IIIa and fbula fracture are
included in the study. Intrarticular fracture, GAIIIb and lost follow
up cases were excluded from the study. Proximal interlocking screws
ORIGINAL ARTICLE
Intramedullary Interlocking Nail in Distal One Third Tibia
Fracture: A Retrospective Study in Tertiary Care Center
Rajiv Baral, Prakriti Raj Kandel, GP Singh, Kishor Man Shrestha, Bipan Shrestha, Sagar Panthi
928
Int. J. of Orth. 2018 June 28; 5(3): 928-931
ISSN 2311-5106 (Print), ISSN 2313-1462 (Online)
Online Submissions: http: //www.ghrnet.org/index.php/ijo
doi: 10.17554/j.issn.2311-5106.2018.05.273
International Journal of Orthopaedics