SHORT TERM FUNCTIONAL OUTCOME OF CLOSED REDUCTION AND FIXATION OF TIBIA SHAFT FRACTURES USING UNREAMED ENDERS NAIL IN ADULT POPULATION - A PROSPECTIVE STUDY

Most of the tibial shaft fractures are the result of high energy trauma. There are various non surgical and surgical methods for managing tibial shaft fractures ranging from conservative casting, tubular external fixator, ring external fixator, open reduction and plating, reamed intramedullary interlocking nailing and unreamed intramedullary nailing. Aim of the study was to evaluate the functional outcomes of closed reduction with unreamed enders nailing as a definitive treatment option for closed tibial shaft fractures in adult population. In the study we included 150 adult patients who had sustained closed tibial fractures and underwent closed reduction and fixation with unreamed enders nailing within 12 hours of the injury. Eye of the nail, present at the distal end of the nails was locked. Total surgical time was averaged to 27.6 minutes. Evaluation was done by the time of clinical union, time of radiological union and VAS score. Ten patients had a delayed union. Two patients developed infection which was managed with oral antibiotics. In the conclusion, we found out that unreamed enders nailing procedure preserves the periosteum and its blood supply due to minimal exposure and improves the healing of fracture and decreases the incidence of infection. This method reduces the operative time, has a relatively less learning curve, reduces fluoroscopic exposure, reduces blood loss, reduces infection rate, doesnt expose the joint thus maintaining its congruity, reduces the cost of implant, reduces patient hospital stay, reduces the antibiotic usage and the implant removal at a later stage can be done as a day care procedure.