Comparison of Results of Interlocking Nailing of Tibia with or without Fibular Plating in Distal Third both Bone Fractures

Ashok, S (2017) Comparison of Results of Interlocking Nailing of Tibia with or without Fibular Plating in Distal Third both Bone Fractures. Masters thesis, Thanjavur Medical College, Thanjavur.


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INTRODUCTION : Injuries to the leg are a common occurrence in our country due to an ever increasing road traffic and various other modes of injury. Fractures of the distal third of the tibia and fibula are very commonly encountered in an emergency trauma department. The availability of many implants and techniques has resulted in no clear cut scheme to manage these fractures. AIM OF THE STUDY: The aim of our study is to evaluate the influence of fibular plating in providing stability to the construct and reduction in valgus deformity of the resultant fixation, when the tibia is stabilised by an intramedullary interlocking nail. HYPOTHESIS: We hypothesised that open reduction and internal fixation of fibula with an 1/3rd tubular plate will aid in tibial fixation using intramedullary nail and also be helpful in the reduction of the post-operative valgus deformity. MATERIALS AND METHODS: 25 patients diagnosed with fractures of tibia and fibula at the distal third level were included in this prospective case control study. The patients were divided into two groups, Group I (control group) - who were stabilised only with intramedullary nail for tibia and Group II (study group) – who opted for fibular plating followed by intramedullary nailing for tibia. Patients were followed up till union and radiographs taken along with valgus angle measurements at the end of follow up period. RESULTS: The mean pre-operative valgus angle in the two groups were 8.37⁰ and 11.37⁰ respectively (p = 0.09 > 0.05). The mean valgus angle post operatively was 4.36⁰ and 4.96⁰ respectively (p = 0.24 > 0.05). The average difference between pre and post-operative valgus angle was 4.0067 and 6.34 in the two groups. Percentage of correction achieved in group I was 47.8% and group II was 55.7%. CONCLUSION: The average individual valgus correction at the end of the study was comparable in both the groups, but the notable fact was the extent of correction obtained from the pre-operative valgus measurement, which was more appreciable in the group that received fibular plating. Hence it was concluded that fibular fixation indeed offers a significant improvement in the outcome apart from aiding in reduction of concomitant tibia fracture in intramedullary nailing. Furthermore it does not lead to increase in any other complications.

Item Type: Thesis (Masters)
Additional Information: Reg. No. 221412201
Uncontrolled Keywords: tibia, fibula, distal one third, fractures, fibular plating, intramedullary nailing, valgus.
Subjects: MEDICAL > Orthopaedics
Depositing User: Devi S
Date Deposited: 19 Mar 2020 06:01
Last Modified: 19 Mar 2020 06:01

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