Distal metaphyseal tibial fractures: Is an IMIL nail an adequate implant? An observational study on the functional and radiological outcome

Abstract

The purpose of this study is to evaluate the functional outcome as well as radiological outcome of distal metaphyseal tibial fractures treated with intramedullary interlocking nail after 6 months post surgery in terms of degree of functionality preserved and degree of malalignment respectively. This was an observational study conducted with 38 patients. Data was retrieved from the MRD. Patients were clinically assessed at 6 months interval and as and when needed by Karlstorm and Orleud Score. Fracture alignment post operatively and radiological union in two standard perpendicular (AP & Lateral) views were assessed. In patients operated in the past, their immediate post-operative and 6 month follow up x-ray was accessed. Functionality was assessed by available information in the patient chart and from present followup. 6 cases (20%) had excellent results, 16 cases (55%) had good results, 7 cases (24%) had fair result (satisfactory/moderate) mostly for minor complaints of knee pain, ankle stiffness. 7 patients were unavailable for assessment of functionality. 1 patient had expired due to natural causes in conclusion Interlocking Intramedullary Nailing for Distal Metaphyseal Tibial Fractures is an acceptable line as it helps with early mobilization of the patient which helps in healing of the fracture and prevents joint stiffness thereby restoring complete motion. The construct is biomechanically stable. Fibular fixation with rush nails predisposed to delayed union, hence plating is recommended or revision of rush nailing to plating when feasible.