The results of fifty two fractures of the tibial shaft, treated by intramedullary nailing were reviewed. These were either closed fractures (65.38%) or open fractures (34.62%). There were 9 fractures of the upper third. 16 of the middle third, 19 of the lower third of the tibia and &fractures were segmental. We had a union rate of 98.1% of cases without the need for any further surgical intervention. Only one patient (1.9%) reguired renailing and fibular asteotomy at 10 months to achieve union 3 months later. There were 6 cases (11.53%) of delayed union more than 6 months. We had an infection rate of 9.6% (five cases, all cleared without fiirther consequences) and malunion occured in five patients (9.6%). Other minor but common complications, include persistent ankle oedema in 10 patients (19.2%). and patellar tendinitis in 7 patients (13.5%). In conclusion locked nailing is a very efficient method of treatment of complex fractures that have not found better method e.g. comminuted fractures, segmental fractures and fractures with bone loss. Even in other fractures amenable to other modes of treatment, it offers a valid alternative with all the penifits of closed nailing, early weight hearing and load-shearing properties. |
