ROLE OF DYNAMIZATION IN INTRAMEDULLARY NAILING OF TIBIA
DOI:
https://doi.org/10.22159/ajpcr.2024.v17i5.50246Keywords:
Tibia fracture, Dynamization,, Intramedullary nailingAbstract
Objectives: This study aims to know the functional outcomes of intramedullary nailing (IMN) osteosynthesis in long bone shaft fractures among adult patients with stable internal fixation and union. Additionally, it seeks to assess the specific and general complications experienced by both groups.
Methods: The study was conducted at the Department of Orthopedics, Government Medical College, and Rajindra Hospital in Patiala, spanning from March 2021 to December 2022. It was a prospective, manipulative, controlled study involving a total of 40 cases of tibia diaphyseal fractures that were presented to the orthopedics department. Fractures were classified according to the AO fracture classification.
Results: The average time for union in the dynamic group was 15.60 weeks (with a standard deviation of 1.27). A significant statistical difference was observed, favoring the dynamization nailing group (p<0.01), indicating a strong trend toward faster union. Out of the 40 patients, 16 (40%) experienced at least one complication. In conclusion, dynamic IMN osteosynthesis permits micromotion between fracture fragments, directly stimulating bone formation and the development of callus.
Conclusion: For closed or open tibial diaphyseal fractures with minimal comminution (types A and B based on the AO classification) up to Gustilo 3A, dynamic IMN assembly is considered a safe and effective treatment option.
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References
Bong MR, Koval KJ, Egol KA. The history of intramedullary nailing. Bull NYU Hosp Jt Dis. 2006;64(3-4):94-7. PMID 17155917
Egol K, Koval KJ, Zuckerman JD. Handbook of Fractures. United States: Lippincott Williams and Wilkins; 2012 Mar 28.
Groves EW. On the application of the principle of extension to comminuted fractures of the long bone, with special reference to gunshot injuries. J Br Surg. 1914 Jan;2(7):429-43.
Garnavos C, Kanakaris NK, Lasanianos NG, Tzortzi P, West RM. New classification system for long-bone fractures supplementing the AO/OTA classification. Orthopedics. 2012 May 1;35(5):e709-19. doi: 10.3928/01477447-20120426-26, PMID 22588414
Kim PH, Leopold SS. In brief: Gustilo-anderson classification. Clin Orthop Relat Res. 2012 Dec 1;470(12):3270-4. doi: 10.1007/s11999-012-2642-7
Plumarom Y, Wilkinson BG, Willey MC, An Q, Marsh L, Karam MD. Sensitivity and specificity of modified RUST score using clinical and radiographic findings as a gold standard. Bone Jt Open. 2021;2(10):796-805. doi: 10.1302/2633-1462.210.BJO-2021-0071.R1, PMID 34587782
Hernández-Vaquero D, Suárez-Vázquez A, Iglesias-Fernández S, García-García J, Cervero-Suárez J. Dynamisation and early weight-bearing in tibial reamed intramedullary nailing: Its safety and effect on fracture union. Injury. 2012 Dec 1;43:S63-7. doi: 10.1016/S0020- 1383(13)70182-7, PMID 23622995
Khan IA, Ahmad S, Shah MA, Ahmed S, Shafiq M, Shafaq SA. Static versus dynamic inter locking intramedullary nailing in fractures shaft of femur. Gomal J Med Sci. 2015 Jun 30;13(2):108-8.
Reddy PK, Reddy PA. Closed intra-medullary interlocking nail improves surgical and functional outcome of diaphyseal fracture of Tibia-our experience. Int J Sci Res Manag. 2015;3.
Somani AM, Saji MA, Rabari YB, Gupta RK, Jadhao AB, Sharif N. Comparative study of static versus dynamic intramedullary nailing of tibia. Int J Orthop. 2017;3(3):283-6.
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