Retrograde Enders Nail –An Excellent Option For Tibial Shaft Fractures With Compound Wound Over And Around The Knee
Journal Title: International Journal of Orthopaedics Traumatology & Surgical Sciences - Year 2018, Vol 4, Issue 1
Abstract
Aims & Objectives: A mode of treatment using retrograde enders nailing for compound (Gustillo- Anderson type 2 and type 3A) tibial shaft fractures with wound over and around the knee where intermedullary nailing is not possible at early phase. Materials And Methods: 30 patients of either sex above 20 years with compound tibial shaft fractures (Gustillo- Anderson type 2 and type 3A) with wound over and around the knee were included in this study. All patients were briefed about the surgery, informed consent for surgery and use of data for study were obtained. Patients with G.A. type 1 and 3B and above open fractures, fractures primarily treated with external fixator and intra-articular fractures were excluded from this study. Results And Observations: Out of the 30 patients, there was an increased incidence of fracture in the 20-40 years age group. 27 patients showed union within 15 weeks of surgery, 3 patients showed union within 15-20 weeks. Average union time was 13.1 weeks with no significant difference.The patients were evaluated with respect to range of motion, time to union, and complications. Conclusion: Retrograde Enders nailing shows satisfactory functional and radiological outcomes in the treatment of tibial shaft fracture. The compound nature of wound over and around the knee impeded the insertion of intramedullary device (intermedullary V nail / Interlock nail). Short operative time, minimal invasive techniques, dynamic controlled motion at fracture site leading to early callus formation which is favorable biomechanically and biologically and sufficient stability in all planes that allows early motion without additional fracture support with usage in segmental fractures, poor skin condition, osteoporotic bones lends credence to Enders nailing being a viable treatment option for tibial shaft fractures. Also in such type of injuries all the complications encountered with external fixators are negated with the use of this device.
Authors and Affiliations
Sunil H Shetty, Amit Dhond, Saikiran R Gudala, Shrikanth Eknath Shinde
Keywords
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