Complications of closed reamed intramedullary nailing inDiaphyseal closed fractures tibia.

Abstract

Fractures tibia are common and many modalities for the treatment are available the most recent one is intramedullary nails with closed and reamed method, however other modalities like casting are still used. Objectives: To evaluate the complications of closed interlocking intramedullary nailing in closed diaphyseal fractures of tibia regarding the infection rate, time for union, malalignment and knee joint pain and stiffness.Design: Prospective study.Setting and Timing: Department of orthopedic surgery in Al-Kadhmiya Teaching Hospital from Dec. 2007- Dec.2009.Patient and Methods : All the patients admitted to the emergency department of the hospital and operated within 72 hours . The study is based on 35 patients including males and females having closed tibial diaphyseal fractures of skeletally mature persons (closed proximal and distal physes)Results: Out of the thirty five (35) patient, follow up was missed in two patients, the other (33) patients were followed for a period of one year. The mean time for union was 14.4 weeks. Union rate was 91 %, delayed union in two patients (6 %). Non union in one patient (3%). Infection was noticed in three patient (9%). Loss of the reduction in two patient (6%) in a proximal third fracture. Knee joint pain in four patients (12.1%) all of them of mild grade and easily ignored.Conclusion: From the study we concluded that closed intramedullay nailing of closed tibia diaphyseal fractures is advantageous because of early mobility, low risk of infection, good union rate, low risk of malalignment and low risk of significant knee joint pain.