CHEAP, SAFE YET EFFECTIVE MANAGEMENT OF DELAYED UNION OF TIBIA IN A LIMITED RESOURCE SET UP.

Abstract

Dr. Santhosh Kumar M. N,

Corresponding Author: Corresponding Author: Dr. Santhosh Kumar M. N,Sandeepani, Mudiyurkara, Gandhinagar P.O.,Kottayam- 686008, Kerala.E-mail: drmnskumar@yahoo.co.inDOI: 10.18410/jebmh/2018/471 ABSTRACTBACKGROUNDTraumatic bone injuries are ever on the increase following a steep rise in road traffic accidents and other high velocity injuries. The number of primary surgeries and repeat surgeries as well are also hence on a steady increase. The limited infrastructure facilities, patient overload, and economic constraints of the patients’ as well as the institutes’, are problems that are encountered. MATERIALS AND METHODSThe study was conducted in Government Medical College, Kottayam, Kerala. Study group included both males and females, mainly males. The age group of patients varied from 20 years to 64 years. The period of study was from June 2013 to January 2018. There were 48 patients: 40 were males and 8 were females. The cases included closed fractures in 30 and open fractures in 18. The fracture pattern included simple as well as mildly comminuted with two patients having butterfly fragment. RESULTSOf the 48 patients in this study group during June 2013 to January 2018 study period, all ended up in solid union at the end of the treatment period. Two patients with butterfly fragment along with comminution were given bone marrow injection at the site of butterfly fragment gap at the first follow up to enhance union and finally united at the end of third follow up i.e., at the end of 4 ½ months after the intervention. The time period for symptom free union from the onset of this interventional treatment varied from 6 weeks to 4½ months. CONCLUSIONDelayed union occurring in fracture tibia which has been treated initially by ILN can be managed by a minimally invasive way in a group of patients by a relatively minor surgery as well as combining the advantages of functional cast bracing to permit early return to pre-morbid activities.

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