Management of Metaphyseal Tibial Fractures by Expert Tibial Nail System

Abstract

Background: Metaphyseal tibial fractures contain distal and proximal metaphyseal fractures which account for (3-11%) and (5-11%) of total tibial fractures, respectively. Numerous treatment options exist for treating metaphyseal tibial fractures.

Objectives: The aim of the current work was to assess the clinical and radiological functional outcomes of expert tibial intramedullary nail in treatment of metaphyseal tibial fractures in adult.

Patients and Methods: This prospective study included a total of 12 patients who had metaphyseal tibial fractures, attending at Zagazig University Hospital and Damietta Specialized Hospital. Patients were operated by closed reduction and internal fixation with expert interlocking tibial nail and followed up for average 6 months from November 2019 to December 2020.

Results: All patients underwent full history taking, Clinical examination and Radiographic views were taken for other skeletal injuries if suspected. 2 patients (16.7%) has proximal tibial fracture, 1 (8.3%) of them had excellent final result and 1 (8.3%) had good final result. 2 patients (16.7%) had segmental tibial fracture,1(8.3%) of them had excellent final result and 1 (8.3%) had fair final result. 8 (66.7%) patients had distal tibial fractures, 6 (50%) had excellent final result, 1 (8.3%) had good final result,1 (8.3%) had poor final result.

Conclusion: It could be concluded that intramedullary fixation with expert interlocking tibial nail is a safe and effective method for the treatment of metaphyseal tibial fractures. Multiple reduction aids as percutaneous clamps, blocking screws/wires help in obtaining and maintaining reduction. The nail design allows the distal or proximal segment to be controlled through placement of multiple locking screws within a small distance from the articular surface. The alignment can be well maintained despite the short metaphyseal segment. Expert nail showed excellent and good results in more than 83% in this study.