20. Outcome of Open Fractures of Tibia Treated with Interlocking & Intermedullary Nail in Terms of Infection and Union
Umair Ahmed1, Mudassar Hassan2, Ubaid Ullah Khan3 and Zubair Khalid1
ABSTRACT
Objective: To find out the outcome of Gustilo Anderson Type I,II,III, A open fractures of tibia treated with intramedullary nail.
Study Design: A case series study
Place and Duration of the Study: This study was conducted at the Department of Orthopaedic Surgery, Ghurki Trust Teaching Hospital, Lahore from January 2019 to December 2019.
Materials and Methods: This case series study was done evaluating 60 patients presenting to us with Gustilo-Anderson I, II and III A open tibial fractures (OTFs). All patients were aged 18-70 years and had open diaphyseal tibial fractures. All included patients had a minimum follow up period of 6 months. All patients were managed adopting pre-op antibiotics, prompt debridement, fixation and primary closure. Demographic data of all cases along with mechanism of injury, time of fixation, flap coverage, union and infection rates were noted.
Results: Overall, mean age was noted to be 37.17+13.5 years. Majority of the patients, 55 (91.7%) were male. Left side was turned to be involved in majority of the cases, 32 (53.3%). Road-traffic accidents (RTA) were found to be commonest mechanism of injury. Overall, mean time to union was noted to be 35.8+8.17 weeks. Union was observed in 46 (76.7%). Comparatively, older age and smoking were also found to be significantly associated with delayed union (p<0.05). Infections were recorded among 14 (23.3%) cases. Infection was found to be significantly more common among older age and smokers (p<0.05).
Conclusion: Rates of delayed union and infections are high among GustiloAnderson Type IIIA open tibial fracture cases treated with intramedullary nailing. Comparatively younger age and no history of smoking were found to have significant relation with union and no infection post-surgery.
Key Words: Open tibial fractures, intramedullary nailing, union, infection.
Citation of article: Ahmed U, Hassan M, Khan U, Khalid Z. Outcome of Open Fractures of Tibia Treated with Interlocking & Intermedullary Nail in Terms of Infection and Union. Med Forum 2020;31(12):90-93.