Evaluation of Results of Combined Blocking Screw and Interlocking Intramedullary Nail in the Treatment of Diaphyseo-Metaphyseal Tibial Fractures

Abstract
Background: Diaphyseo-metaphyseal tibial fractures tend to malalign while treatment by interlocking intramedullary nail. Multiple techniques are used to avoid malalignment as provisional unicortical plate, percutaneous clamping, universal distractor, fibular plating in distal tibia and blocking screw.
Aim of Study: Was to evaluate the results of combined blocking screw and interlocking intramedullary nail in the treatment of diaphyseo-metaphyseal tibial fractures.
Patients and Methods: This study was done on 21 patients with closed proximal or distal diaphyseo-metaphyseal tibial fractures, admitted at Tanta University Hospital. The distri-bution of patients was according to age, sex, and side, mode of trauma, and AO type of fracture, medical history, smoking, fracture level, time lag, fibular fixation and design of inter-locking nail. Fixation was done by interlocking intramedullary nail and the reduction was assisted by blocking screw in the coronal plane for varus or valgus malalignment and in the sagittal plane for recurvatum or procurvatum malalignment. Clinical evaluation was according to Hospital of Special Surgery Knee Rating Scale.
Results: There were significant statistical correlation between the final clinical result and interlocking nail design either conventional or expert tibial nail or the time for union. There were significant statistical correlation between the time of union and sex of patients, mode of trauma, type of fracture, fibular fracture fixation and smoking.
Conclusion: Blocking screw is a simple technique that assist in the reduction of diaphyseo-metaphyseal tibial fractures while fixation by interlocking nail, maintenance of the reduc-tion and stability of the fracture.