Mechanical Effect of Poller Screw in Metaphyseal Fractures of Tibia Fixed by Locking Intra-Medullary Nail

Document Type : Original Article

Authors

The Department of Orthopedic Surgery, Shebeen El-Kom Teaching Hospital* and Faculty of Medicine, Al-Azhar University**, Cairo

Abstract

Abstract Background: Intramedullary nailing of metaphyseal frac-tures may be associated with deformity as a result instability after fixation. Our aim was to evaluate the clinical use of Poller screws (blocking screws) as a supplement to stability after fixation with statically locked intramedullary nails of small diameter. Aim of Study: To evaluate the mechanical effect and clinical outcome of poller screw in metaphyseal fractures of tibia fixed by locking intramedullary nail. Patients and Methods: 15 men and 5 women (20 fractures) aged 19 to 60 (mean, 36.25) years underwent fixation of tibial metaphysis by locking intramedullary nail and poller screw. The mechanisms of injury included motor car accident in thirteen patients, fall from height in two patients, direct trauma in five patients. Radiological and clinical outcome was eval-uated. Results: Twenty patients were followed-up in the outpatient clinic for assessment of fracture healing or the establishment of a nonunion. Union was defined as the healing of at least 3 of 4 cortices on a biplanar radiograph. All the twenty patients (100%) achieved union at average time twenty weeks (ranging from 16 to 24 weeks). Conclusion: Poller (blocking) screws are an important adjunct for intramedullary nailing; aiding fracture reduction at the metaphysis, and offsetting deforming forces that cause malalignment.

Keywords

The Medical Journal of Cairo University
Volume 88, September
September 2020
Pages 1839-1848

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