Outcomes of Distal Third Tibial Shaft Fractures Treated by Modified Interlocking Intramedullary Tibial Nail

Introduction:
Distal third tibial shaft fractures are challenging to manage due to poor
soft tissue coverage and high risk of malalignment and delayed healing.
Modified interlocking intramedullary nailing offers improved stability
and early mobilization compared to conventional methods.
Objective:
This study aimed to evaluate the clinical, radiological, functional, and
structural outcomes of distal third tibial shaft fractures treated with the
modified interlocking intramedullary tibial nail.
Methods:
This prospective observational study was conducted in the Department of
Orthopaedic Surgery at the National Institute of Traumatology and
Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh from July 2016
to June 2018. A total of 30 patients aged between 18 and 65 years of both
sexes, presenting with distal third tibial shaft fractures (AO classification
types 42A1–3 and 42B1–3) were included. Data was analyzed using the
Statistical Package for Social Sciences (SPSS), version 22.
Results:
In this study of 30 patients with distal third tibial shaft fractures treated
using a modified interlocking intramedullary tibial nail, the majority
achieved radiological union within 16–18 weeks and full weight
bearing by 14–16 weeks. Most patients experienced no pain, deformity,
or significant motion loss, with 90% showing excellent-to-good
functional recovery per the Karlström–Olerud score. Overall, the
procedure provided stable fixation, rapid healing, and satisfactory
functional and structural outcomes with minimal complications.
Conclusion:
Treatment of distal third tibial shaft fractures with the modified
interlocking intramedullary tibial nail yields excellent clinical,
radiological, functional, and structural outcomes with minimal
complications.