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Year : 2021  |  Volume : 29  |  Issue : 2  |  Page : 42-47

Intramedullary expert tibial nailing of distal tibial fractures: Functional outcomes with a midterm follow-up

Department of Orthopaedics, Government Medical College, Srinagar, Jammu and Kashmir, India

Correspondence Address:
Zubair Younis Ringshawl
Department of Orthopaedics, Government Medical College, 152, S-3, L-4, Gulberg Colony, Hyderpora, Srinagar 190014, Jammu and Kashmir.
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijors.ijors_25_21

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Background: The tibial diaphysis is the most common site of fracture in the tibia and approximately 80% of these fractures have associated fibular fractures. Expert Tibia Nail System (ETNS) system provides extra stability in comparison to conventional intramedullary tibial nail due to multiaxial locking system. Objective: The aim of this study was to evaluate the midterm functional outcome of distal tibial fractures using the ETN. Materials and Methods: This prospective study was conducted from June 2016 to August 2019 comprising a total of 30 cases who were treated by Expert tibial nail fixation for distal tibial fractures. Clinical evaluation was done at each follow-up and final evaluation was done at 9 months postoperatively. The evaluation method at 9 months follow-up was the clinical examination and radiographic imaging. Results: Of 30 patients, majority were men. Male-to-female ratio was 3:1 with 22 men (73.33%) and 8 women (26.66%). The mean age of patients was 32 years with a range from 20 to 60 years. Left limb was involved more 16 (53.33%) frequently than right 14 (46.66%). Majority of the patients had trauma due to road traffic accidents (46.66%), fall from height/stairs (26.66%), twisting injuries (23.33%), and sports injuries (3.33%). There were 1 patient with superficial infection which resolved with wound care and antibiotics, 2 with anterior knee pain, 1 with malunion, 1 with delayed union, and 1 patient with nonunion. According to Johner and Wruh’s criteria, excellent results were achieved in 20 patients, good in 5 patients, fair in 4 patients, and poor in 1 patient. Conclusions: Expert tibial nailing is a new and innovative procedure for distal tibial fractures. It is safe and effective with the added advantage of providing additional stability and preventing rotational malalignment for distal third tibial fractures in comparison to conventional nailing. Further studies need to be conducted to validate the advantages of this procedure over conventional nailing.

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