Abstract
The study is a prospective evaluation and comparison. Eighty-two patients with tibial shaft fractures were treated with intramedullary fixation by either an unlocked nail (ULN) or an interlocked nail (ILN). All patients were followed up for 12 months with a functional score evaluation. The patients were divided into two groups, based on the method of treatment. The ULN group included 42 patients with an average age of 43.1 years. The ILN group included 40 patients with an average age of 40.0 years. Both groups were similar in the injury mechanism, fracture location, open fracture type and associated medical conditions (all P > 0.05). The operative time was shorter and the wound size smaller in the ULN group when compared to the ILN group (P < 0.001). The union rate, healing time and malunion rate were not significantly different between the two groups (P > 0.05). Although the functional score showed no difference between the groups (P = 0.3), the ILN group had a greater ability to return to their work 6 months after surgery (P = 0.03). In conclusion, unlocked nailing for tibial shaft fractures is a simple and effective method especially in the treatment of middle-third fractures. Interlocked nailing gives stable fixation without cast immobilisation, which resulted in a greater ability for the patients to return to their previous work 6 months after surgery.
Résumé
Etude prospective et comparative de 82 patients avec une fracture de la diaphyse tibiale traitée par clou centro-médullaire non vérrouillé (ULN) ou vérrouillé (ILN). Tous les patients étaient suivis 12 mois, avec une évaluation fonctionnelle. Le groupe ULN comprenait 40 patients d’âge moyen 43.1 ans. Le groupe ILN comprenait 40 patients d’âge moyen 40 ans. Les deux groupes étaient similaires pour le mécanisme, la localisation de la fracture, le type d’ouverture, et les conditions médicales générales. (tous les P > 0.05). Le temps opératoire est plus court et la taille de l’incision plus petite dans le groupe ULN (P < 0.001). Le taux de consolidation et le temps de consolidation ne sont pas différents entre les deux groupes (P > 0.05). Bien que le score fonctionnel ne montre pas de différence entre les deux groupes, le groupe ILN à une plus grande facilité à la reprise du travail 6 mois après la chirurgie (P = 0.03). En conclusion l’enclouage non vérrouillé est une bonne méthode surtout dans les fractures du tiers moyen de la diaphyse tibiale. L’enclouage vérrouillé procure une fixation stable sans immobilisation platrée donnant une plus grande capacité de reprise des activités antérieures 6 mois après la chirurgie.
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Lee, YS., Lo, TY. & Huang, HL. Intramedullary fixation of tibial shaft fractures: a comparison of the unlocked and interlocked nail. International Orthopaedics (SICO 32, 69–74 (2008). https://doi.org/10.1007/s00264-006-0271-z
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DOI: https://doi.org/10.1007/s00264-006-0271-z