Tertiary Care Orthopedic Hospital Experience to Find Effect of Dynamisation in Delayed Union Tibia Shaft Fracture

Abstract

Objective: Our study was designed to evaluate the effect of dynamisation in delayed union tibia shaft fractures. Methodology: This prospective study was conducted at the Orthopedic Department, Shaheed Mohtarma Benazir Bhutto Medical College, from March 2020 to March 2021. During this timeframe total of 20 patients who underwent dynamisation for reamed intramedullary nailing were recruited. After two successive visits, those patients whose fracture failed to show progressive signs of callus formation underwent dynamisation. We removed the single static screw from the longer fracture segment to perform the dynamisation procedure. We inserted a poller screw slightly medial to the nail from anterior to posterior to provide additional stability to the proximal fragment. Statistical analysis was performed by using SPSS 23.0. For evaluating the success of dynamisation Chi-square test was used. Results: The mean age of recruited patients was reported as 35.92 years ranging from 16 years to 63 years old. Out of these twenty cases, 17 were male (85%). The mean time duration of nailing was reported as 35.4 hours. Total fourteen patients were immediately treated with nailing within 20 hours of injury, while the rest six underwent delayed nailing. Total four cases of tibial fracture were turned out as failure because the patient failed to achieve union after dynamisation and underwent augmentation plating with bone grafting for the complete union. Conclusion: Delayed dynamisation is a convenient and cost-effective technique to achieve union in femoral shaft fractures. Overall, our study reported an 80% success rate but failed to achieve early dynamisation in comminuted fractures.