Modalities of treatment for segmental tibia fracture
Author(s): Prashant Patel, Ketan Kakani, Pratik Prajapati, Viral Prajapati, Sandeep Patil
Background: Segmental tibia fractures (AO 42-C2) are defined by two or more distinct fracture lines isolating an interposed cortical segment which excludes butterfly fragmentation. Severe soft tissue defects are common due to their association with high energy trauma mechanisms of injury.
Objectives: This study is an attempt to observe the various outcome of operative management of segmental tibia fracture treated by various modalities like intramedullary nailing, plating and external fixator. The results have been studied in depth to determine which modality is better for management of this type of fracture.
Material & Methods: This is a prospective study of 25 cases of segmental tibia fracture treated by intra medullary nailing or plating or external fixator with minimum 6 months of follow up. All cases are evaluated according to time of union, complications, range of motion and modified knee society score. Modified knee society Score on residual effects on clinical ground at final examination. Points are given for pain, function and range of motion in modified knee society score.
Result: Mean knee ROM in intramedullary nailing group is 118, while in plating group is 113.33.Average time of union in intramedullary nailing group is 18.61weeks; while in plating group is 25.33 weeks. Result according to Modified knee society score was found to be excellent to good in 18(72%) patients.11(73%) patients treated by interlocking intramedullary nailing had excellent to good knee score.
Conclusion: Interlocking intramedullary nailing is a excellent method of treatment for the segmental tibia fracture as it provides rotational stability, gives excellent to good result, lower rate of complications and good knee ROM.