Segmental tibial fractures treated with unreamed interlocking nail – A prospective study

Introduction: Fractures of tibia are common and major skeletal injuries. Treatment of such fractures in adults is a challenge to orthopaedic surgeons due to its poor soft tissue coverage and poor blood supply. The aim towards treatment for the segmental fracture tibia is union maintaining normal length, normal alignment without rotational deformity, normal joint movements and reduced hospital stay. Method: In our department since 2012 to 2014, 51 segmental tibia fractures were treated with unreamed interlocking intramedullary nailing technique with one proximal and one distal locking screws. Postoperatively, early mobilization exercises and weight-bearing were begun. The functional results were assessed by measuring union period and knee range of movements at 6 months. Results: Fracture healing was obtained in 49(96%) cases within the expected time period. 2(3.9%) patients had non union between proximal and middle segment. 46 (90%) were anatomic (valgus/varus<50). 5(9.8%) patients had malunion with valgus more than 50. Average range of movement observed at 4 months was 1250 (700-1400). Superficial infections were noted in 2 patients with compound fracture effectively treated with antibiotics. Discussion and Conclusion: We conclude that unreamed interlocking nail fixation in segmental tibial fractures seems to be less time consuming, preserves blood supply, relatively simple and good method of treatment with good functional outcome and patient satisfaction provided proper selection of fracture is done.