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General Orthopaedics

Outcome of expert tibial nailing for distal third tibial fractures

British Orthopaedic Association/Irish Orthopaedic Association Annual Congress (BOA/IOA)



Abstract

Aim

The purpose of the study was to evaluate the results of Expert tibial nailing for distal tibial fractures.

Methods

All patients who had a distal third or distal end fracture of the tibia treated with the Expert tibial nail over a three year period at our institution were included in the study. A total of 44 distal tibial fractures in the same number of patients were treated with the nailing system. One patient died in the immediate post operative period from complications not directly related to the procedure and 3 were lost to follow up leaving a cohort of 40 patients for evaluation. 31 of the fractures were closed while the remaining 9 were open. The average age group of the cohort was 46.8 years with 26 males and 14 females.

Results

All 40 patients were followed up to full radiological union of their tibia fractures. The average time to radiological union was 12.5 weeks for the closed fracture group and 15.1 weeks for the open fractures. The difference in time to union between the two groups was not statistically significant. There was infection around a distal locking screw in a closed fracture which settled with screw removal. Three patients in the closed fracture group required dynamisation to hasten union while none required dynamisation in the open fracture group. No bone grafting was performed on any of the patients. One patient had non union of a distal fibula fracture which required plating of as an additional procedure. On follow-up none of the patients reported knee pain or had limitation of ankle movements.

Conclusion

The Expert tibial nail is an effective implant for the treatment of both open and closed distal tibial fractures with a low complication rate