Abstract

Objective: We conducted a study to evaluate the short-term functional outcomes of patients with an
isolated tibial shaft fracture treated with locked intramedullary nailing. using a prospective clinical
and radiographic assessment, for union time, time of starting full weight bearing, rate of infection,
knee and ankle joint movement, knee joint pain, and malalignment.
Patients andMethods: We had included 56 patients with isolated tibia fractures from our patients
prospectively followed up in period between Febr.2006 and December 2008 (34 months). 56 patients
agreed to present to our timetable of follow up, 4 patient lost after 3 months of follow up .We had a
median follow-up of 10 months. with a range from 6 to 18 months. All patients were initially acutely
treated with locked intramedullary nailing of their tibia within 48 hours of getting injured . All enrolled
patients were evaluated with Functional assessment, and were evaluated radiographically and by
physical examination.
Results: Of the total number (56 patients), 15 (26.7%) patients had at least moderate knee pain.
6 patients out of 52 ( 11 %) got knee joint stiffness . whereas 2 patients ( 4%) had ankle joint
stiffness , both groups treated by a physiotherapy course .in 90% of the patients ,mean time of union
was 15 weeks ranged from 12- 24 weeks. After getting union those patients started full weight
bearing.Totally 4 patients got superficial wound infection ( 7 %) . ( 12 %) got malalignment , all were
in proximal and distal1/3.
Conclusions: We see that locked intramedullary nailing is a suitable procedure for unstable fractures
of tibial shaft .In contrast to open reduction and internal fixation, intramedullary nailing can be
performed initially on the first or second day of admission.
The advantages of IM nailing include better alignment, earlier range of motion of knee and ankle,
better mobility of patient, less frequent follow up visits, and earlier return to work.