Management of Extra-articular Proximalthird Tibia Fractures by Expert Tibia Nail and its Functional Outcome: A Longitudinal Cohort Study

Abstract

Introduction: Tibia, being anatomically placed subcutaneously throughout its length, is very easily prone to fractures. Incidence of extra-articular proximal tibia fractures accounts for 5-11% of all tibia shaft fractures. Among the various treatment modalities available, locked intramedullary nailing is a safe and adequate modality with fewer complications. Expert tibia nail is anatomically designed with multi-directional locking, which attains better angular stability and thereby allowing fixation of very proximal fractures. Aim: To analyse and assess the functional and radiological outcome of expert tibia nailing used for treating extra-articular proximal third tibia fractures. Materials and Methods: A Longitudinal Cohort study was conducted for a duration of three years and five months, which included 31 patients. Standard descriptive statistical method was used to describe parameters. All these patients had extraarticular proximal third tibia fractures and were managed with expert tibia nail. All patients were undergone clinical and radiological evaluation based on the Klemm and Borner scoring system at a regular interval of 6 weeks, three months, six months, and at one year. Results: The most common mode of injury was road traffic accidents (80.64%). Patients were in the age group of 26-63 years with an average mean of 41.80±9.7 years. The male to female ratio was 4.16:1, suggestive of male predominance. According to the Klemm and Borner scoring system, 71.42% of patients belonged to the excellent group, 17.85% were in good, 7.14% in fair and 3.57% in poor. Radiological union was achieved in an average period of 20.9±2.09 weeks. Conclusion: In this study, scores obtained on the basis of Klemm and Borner scoring system, depicts that intramedullary expert tibia nailing is a good treatment modality for the management of extra-articular proximal third tibia fractures, which provides good angular stability and adequate fixation resulting in early rehabilitation and union with excellent functional outcome and mere complications. It is also a safer treatment modality in case of compromised surrounding soft tissue.

Keywords

• long bone injury
• klemm and borner score
• structural anatomy