Assessing the effectiveness of intramedullary nailing for tibial shaft fractures in a low-income setting: a prospective study in Yemen

Eur J Orthop Surg Traumatol. 2024 Feb;34(2):995-1002. doi: 10.1007/s00590-023-03753-1. Epub 2023 Oct 12.

Abstract

Background: Tibial shaft fractures are common injuries that can be treated with various methods, including interlocked intramedullary nail (IMN). However, there is limited data on the clinical outcomes of IMN for tibial shaft fractures in Yemen.

Objective: To evaluate the clinical outcomes of primary IMN for tibial shaft fractures in Yemen.

Methods: This was a prospective study of 134 patients who underwent primary IMN for tibial shaft fractures et al.-Thawra Modern General Hospital in Sana'a, Yemen, between June 2016 and June 2020. The patients were between 18 and 70 years old, and the fractures were classified according to the AO classification system. The fractures were treated with IMN using a standard technique. The patients were followed up for a minimum of 2 years. The outcome measures included union time, complications, and functional scores.

Results: The mean union time was 17 weeks. The overall complication rate was 18.7%. The most common complications were infection (8.2%), delayed union (6.7%), and nonunion (3.7%). The mean functional scores at the final follow-up were 91.4 for the Knee Society Score and 90.2 for the American Orthopaedic Foot and Ankle Society Score.

Conclusion: Primary IMN is an effective and reliable method for treating tibial shaft fractures in Yemen, with acceptable union time, complication rate, and functional outcomes.

Keywords: Fracture fixation; Intramedullary; Tibial fractures; Yemen.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bone Nails
  • Fracture Fixation, Intramedullary* / adverse effects
  • Fracture Fixation, Intramedullary* / methods
  • Fracture Healing
  • Humans
  • Middle Aged
  • Prospective Studies
  • Retrospective Studies
  • Tibial Fractures*
  • Treatment Outcome
  • Yemen
  • Young Adult