RETROSPECTIVE COHORT STUDY OF FUNCTIONAL OUTCOME OF FRACTURE OF SHAFT OF TIBIA TREATED WITH TIBIAL INTRAMEDULLARY NAILING UNDER FIGURE OF FOUR TECHNIQUES FOR 10 YEARS

Abstract

Aravindan Kalamegam, Bharath Narayanasamy, Saravanakumar Kadirvelu, Vignesh Vaithilingam Ramaiyah

BACKGROUND Intramedullary nailing became a standard modality of treating fractures shaft of tibia. Inserting nail by usual technique poses difficulty to surgeons for correcting rotational instability, so in this study our aim is to insert nail in freehand Figure of Four technique, which is easier for the surgeon to correct rotational instability and for intra operative imaging. MATERIALS AND METHODS This study was carried out at department of orthopaedics, Aarupadai Veedu Medical College and Hospital, Puducherry. Subjects included in this study were patients who approached our department with fracture shaft of tibia and were treated with free hand Figure of Four technique. This study was carried from January 2008 to September 2016. Inclusion criteria is Fracture middle and distal 1/3rd shaft of tibia (closed and compound fracture until Gustilo and Anderson classification grade II). Exclusion criteria are 60 yrs., associated fracture in tibial condyle and proximal 1/3rd of shaft of tibia, patient lost for follow-up, pathological fracture, terminally ill patient. Data will be collected based on patients coming to outpatient department and records from medical records department. Results were assessed by Johner and Wruh’s criteria, which evaluated pseudoarthrosis, ostitis, amputation, neurovascular disturbance, deformity in frontal plane, deformity in sagittal plane, rotational deformity, shortening of limb, knee and ankle mobility, pain, gait and heavy activity. RESULTS Results were assessed by Johner and Wruh’s criteria. CONCLUSION Intramedullary nailing for shaft of tibia fracture by freehand Figure of Four technique is easier for surgeon in correcting rotational instability and varus and valgus deformity of the limb and for intra operative imaging and this technique doesn’t pose any new risk compared to other technique.