Evaluation of the treatment of Open Fracture of Tibia by Primary Nailing

Aim: Open fracture of the tibia is most common in road traffic accident specially motor cycle accident. Topics of debate in the orthopaedic traumatology continue regarding the specific methods of bone stabilization and soft tissue management of open fracture of Tibia. Objectives: To evaluate the results of intramedullary nailing in the open fractures of the tibia in Combined Military Hospital, Dhaka. Material and Methods: A prospective study was done from January 2018 to June 2019in Combined Military Hospital, Dhaka. Total twenty cases were selected who sustained open fractures of tibia Gustilo and Anderson grades I, II and IIIA. Primary undreamed intramedullary interlocking nail fixation done after thorough debridement and wounds were closed with suture. All the patients were followed up for a minimum of one year. Results: Of the total twenty cases, ten were of grade I, seven were of grade II and three were of grade IIIA injury. Dynamization was done in nine cases. The average time to union was 16.0 weeks in the grade I cases, 18.3 weeks in the grade II cases and 23.6 weeks in the grade III A cases. The mean time to union was 19.3 weeks. Infection occurred in 3 cases. Mal union was observed in one case of type IIIA. No case had any implant failure (nail / screw breakage), or deep vein thrombosis. Conclusion: From our study we have concluded that the unreamed intramedullary nailing in cases of open fractures of the tibia with soft tissue closure results faster soft tissue and bony healing. Biomechanical stability, early rehabilitation and infection rates are also comparable to those which are seen with other methods. Bangladesh Journal of Medical Science Vol. 23 No. 03 July’24 Page : 638-642