Fixation of Distal Tibial Fractures by Intramedullary Nail with Multidirectional Distal Locking Screws

Abstract
Background: Fractures of the distal tibia involve the diaphyseo-metaphyseal area of the bone, and may be either extra-articular or intrarticular. Several methods have been described for the treatment of these fractures, including casting, external and internal fixation.
Aim of Study: The aim of the work was to evaluate the results of fixation of distal tibial fractures by intramedullary nail with multidirectional distal locking screws (Expert tibial nail).
Methods: This study included 21 patients with distal tibial fractures treated between October 2017 and October 2018 (including follow-up period) at Tanta University Hospital with intramedullary nail with multidirectional distal locking screws (Expert tibial nail). Clinical and radiological data were analyzed.
Results: According to Tenny & Wiss scoring systems for distal tibial fractures the clinical results were graded as excellent in six patients (28.6%), good in nine patients (38.1 %), fair in four patients (19%) & poor in two patients (9.5%).The excellent and good results were considered as satisfactory results while the unsatisfactory included the fair and the poor results. Thus, satisfactory results were found in 15 patients (71.43%), and the unsatisfactory results were found in six patients (28.57%).
Conclusion: Treatment of distal tibial fractures using intramedullary nail with multidirectional distal locking screws (Expert nail) is a safe and accepted method alternative to conventional nail and plating technique. It provides additional biomechanical stability than the conventional nails and plate osteosynthesis.