Fractures of the proximal or distal thirds of the tibia are one of the most challenging injuries in
orthopedic. Several methods have been described m the choice of technique depends on multiple
factors including fracture configuration, bone quality, soft-tissue injury and available
equipment.Intramedullary nailing may be effective in managing these fractures even with simple
articular extension, but care needs to be taken with reduction and adequate screws locking to prevent
malalignment and chronic knee pain may also be an issue. This study included 20patients with distal
and proximal tibial fractures treated with intramedullary nail with multidirectional proximal and distal
locking screws (Expert tibial nail). The period of follow up was up to 6months using certain scoring
systems. The symptomatic and functional evaluation results were graded according to the criteria by
Johner and Wruh’s Criteria According to Johner and Wruh’s criteria, 45.0% of patients showed good
criteria, 30.0% were excellent, 15.0% were fair and only 10.0% were poor. Two cases developed
delayed union (10%), two cases developed Sudeck's atrophy (10%), one case developed malunion
(5%), one case developed nonunion(5%) and anterior knee pain was found in four cases (20%). So
anterior knee pain represented the most common complication in this study.Treatment of proximal and
distal thirds tibial fractures using expert tibial intramedullary nail (with multidirectional locking
screws) is a safe and accepted method alternative to conventional nail and plating technique. This
design of the implant helps in achieving stable fixation and improved locking in most extraarticular
tibial fractures |
