Fractures of Tibia Diaphysis Managed with Internal Fixation by Elastic Nails: An Alternative Approach

Background: Intramedullary nailing techniques specially using elastic nails like Enders nail are a good treatment option, owing to their cost effectiveness, less use of fluroscopy and ease of procedure with short learning curve. This study is aimed to bring evidence to the hypothesis that Ender nails can be used successfully in tibia shaft fractures under certain indications. Due to the economic nature and easy procedure, we aimed specifically to demonstrate that elastic IM nailing, esp. Ender nails can be a good alternative to interlock nailing for select cases of diaphyseal fractures. The study aims at evaluating outcome of Enders nail in diaphyseal tibia fractures.

Material and Methods: This study was carried on in the Department of Orthopaedics, tertiary care hospital during the period of April 2019 to March 2020. It is a prospective type of study. Patients were evaluated based on functionality and radiology, post-surgery.

Results: A total of 30 patients of tibial shaft fractures were selected and managed with closed reduction and internal fixation with Enders nail. Male to female ratio was 4:1. 24 (80%) patients sustained injury from motor vehicular accidents. 40% patients with open fracture and 60% closed fracture patients were involved. 60% if the patients showed clinic-radiological union in 12-14 weeks, while 50% of the patients achieved a post operative knee range of movement of 0 to 131-140 degrees.

Conclusion: Closed reduction with internal fixation by Enders nail can be a good alternative for management of tibia diaphysis fractures, when performed after proper patient selection and patient counselling.