EXTRA ARTICULAR DISTAL TIBIAL METAPHYSEAL FRACTURES BY INTRAMEDULLARY INTERLOCKING NAILING-A SHORT TERM ANALYSIS

Abstract :

Fractures of tibia is a controversial subject despite advances in both non-operative and operative care. The treatment should realign the fracture, realign limb length and early functional recovery. Management of distal tibial metaphyseal fractures can be a difficult task. There is relatively little information on their treatment in literaturesfor these fractures are different from proximal diaphyseal fractures and distal intra-articular pilon fractures in terms of the mechanism of injury, treatment principles and prognosis .Treatment varies according to the proximity of the fracture to the plafond, fracture displacement, comminution, and injury to the soft-tissue envelope. surgical fixation like open reduction and internal fixation have been associated with poor results, including soft tissue devitalization, skin slough and infection.Conservative management to avoid these complications has resulted in unacceptable deformity and loss of ankle range of motion to avoid soft tissue complications Minimally invasive surgical techniques have been developed which provides stability and alignment offered with internal fixation.Many techniques have emerged: hyid external fixation, external fixation with limited internal fixation, percutaneous plate osteosynthesis and intramedullary nailing Intramedullary nailing of open and closed tibial shaft fractures have shown high rates of radiographic and clinical success, but the use of this procedure has not become widely accepted for distal metaphyseal fractures

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