Evaluation of Functional Outcome of Patients with Extra Articular Distal Tibia Fractures Treated by Intramedullary Nailing at Government Medical College, Thrissur – A Prospective Study During March 2022 to December 2022

Background: Distal tibia fractures that involve the tibial metaphysis often pose significant challenge to the Orthopedic surgeons. The relatively lesser vascularity, the subcutaneous location and the close proximity to the ankle joint which is of the hinge configuration, responsible for major weight transmission and its complex biomechanics results in high incidence of complications including malunion. Methods: 61 Patients who had distal tibia fractures and fixed with IM nailing were prospectively followed up was performed on patients treated with intramedullary nailing for extraarticular distal tibia fractures during the period from March 2022 to December 2022 in the Department of Orthopedics Government Medical College Thrissur. On follow up, patients were clinically assessed by at the end of 3 ,6 and 9 months, Radiological parameters were recorded with anteroposterior and lateral view of the limb. Functional scores like the American Orthopaedic Foot and Ankle Society Score and Olerud and Molander Scores were calculated using appropriate patient questionnaires Functional scores were analysed statistically using STATA 14.0 version software. Results: Out of the 61 patients recruited for the study, 50 patients were males and 11 were females.82%(n=50) sustained the injury due to high velocity injury.57.4%(n=35) patients sustained closed fractures. The average time to surgery was 4.18 days. And the average time taken to partial weight bearing was 12 weeks. The mean AOFAS score was 87.12; assessed at 3 months from date of surgery and 89.4 when assessed 6 months from the surgery. The mean Olerud and Molander score was 80.24 at 3 months and 83.7 at 6 months from the date of surgery. Conclusions: Intramedullary nailing achieved consistent union and good functional outcome in patients with distal tibia fractures. AOFAS score and Olerud and Molander score are good scoring systems to assess the functional outcomes in patients with distal tibia fracture. However, there is significant incidence of implant related pain in patients who had IM nailing.