Tibia Fracture Essay

The goal of fracture treatment is to obtain union of the fracture in the most compatible anatomical position which allows maximal and full restoration of the extremity. Distal tibia fractures are primarily located within a square based on the width of the distal tibia1.On the basis of the fracture location in the bone, distal tibia fractures have the second highest incidence of all tibia fractures after the middle fracture of tibia2. The management of these fractures is often more complex than the diaphyseal fractures because of its unique anatomical characteristics of subcutaneous location with precarious blood supply and proximity to the ankle joint, leading to the potential for postoperative complications and poor outcome3. Considering its anatomy, it is

After scrubbing, painting and draping, a vertical patellar tendon splitting incision was taken. The entry point was taken slightly distal to the tibial plateau, just medial to lateral tibial spine and in line with the medullary canal on lateral view.After widening the medullary canal with a curved awl a guide wire was passed into the proximal fragment. Reduction of the fracture fragments under image intensifier by maintaining longitudinal traction in line of the tibia was done. After reduction, the tip of the guide wire was passed till it entered the subchondral bone of distal tibia, followed by reaming of the canal.A proper size nail was then assembled over zig and was passed over the guide wire. Distal locking was done by free hand technique assisted by image intensifier. Cases in which the distal fragment was large enough to accommodate two medio-lateral screws, two medio-lateral screws were passed, and cases in which distal fragment was too small one medio-lateral and one anteroposterior screw were passed. Proximal locking was done with the help of the zig. Static locking was applied in all cases. Wounds were closed