Interlocking nailing of lower limb fractures at the University of Port Harcourt Teaching Hospital
Keywords:
SIGN, Intramedullary nail, fractures, UPTHAbstract
Introduction: The interlocking intramedullary nail has become the standard treatment for most long-bone diaphyseal and selected metaphyseal fractures. The Surgical Implant Generation Network (SIGN) intramedullary nail is a set designed for use in treating patients in resource poor regions who need, but cannot afford an intramedullary interlocking system.
Aim: To analyze the demographics, pattern of injuries and surgical outcome of patients with lower limb fractures treated with the SIGN interlocking nails at UPTH.
Methods: All patients who had intramedullary nailing of lower limb long bone fractures between March 2013 and March 2016 using the SIGN nails were included in this study. Details on demographics, bone fractured and surgical technique were collected using the SIGN database pro-forma.
Results: Fifty one surgeries were performed on forty eight (48) patients, fourteen females and thirty four males. Male/ female ratio was 2.4/ 1 and ages ranged between 18 to 90 years, the mean age being 38.7 years. Thirty seven patients had femoral fractures (72.5%) while 14 patients had tibial fractures (27.5%), 3 patients had floating knees. Total complication rate was 10.5%, and included two cases of surgical site infection (4.2%), one case of post- operative bleeding and one case each of missed distal interlock and implant failure.
Conclusion: The advantages of interlocking intramedullary nail fixation of long bone diaphyseal fractures have been well documented. The use of an external jig makes distal interlocking possible in areas where image intensifiers are unavailable.
References
Lewis G. Zirkle Jr. Technique Manual of SIGN IM Nail & Interlocking Screw System Insertion & Extraction Guide, www.sign-post.org; 2008.11.15
Ranjeet N, Sapkota K, Onta P, Thapa P, Thapa UJ, Gupta MK. SIGN Nail Experience in Manipal Teaching Hospital. American Journal of Public Health Research 3, no. 5A (2015): 115-118
Feibel RJ, Zirkle Jr. Use of interlocking intramedullary tibial nails in developing countries. Tech Orthop 2009;24: 233–46.
Lawrence Akinyoola, Olaniran Orekha, Afolabi Odunsi Open intramedullary nailing of neglected femoral shaft fractures: Indications and outcome. Acta Orthop. Belg., 2011; 77: 73-77
Manoj Kumar Chakraborty, Pabin Thapa, Brijesh Sathian ;Surgical Implant Generation Network (SIGN) Solid Intramedullary Interlocking Nail in the Lower Extremity: An Observational Study from Western Nepal ;Journal of Clinical and Diagnostic Research. 2011 December; Vol-5(8): 1614-1617
Bong MR, Kummer FJ, Koval KJ, Egol KA. Intramedullary nailing of the lower extremity: Biomechanics and biology. J Am Acad Orthop Surg 2007 February; 15(2): 97-106.
L. N. Gakuu , Comprehensive global evolution of intramedullary nailing of diaphyseal fractures, East African Orthopaedic Journal 2009; 3: 36-39
Ikpeme Ikpeme, Ngim Ngim, Anthony Udosen, Obiora Onuba, Okokon Enembe, Segun Bello, External jig-aided intramedullary interlocking nailing of diaphyseal fractures: experience from a tropical developing centre, International Orthopaedics (SICOT), 2011; 35:107–111
Ikem IC, Ogunlusi JD, Ine HR, Achieving interlocking nails without using an image intensifier. Int Orthop. 2007 August; 31(4): 487–90. 10. Toivanen JA. The management of closed tibial shaft fractures. Current Orthopaedics 2003;17:167-75
Dahiru IL, Amaefule KE, Lawal YZ, Ogirima MO, Maitama MI, Ejagwulu F, et al. Locked intramedullary nailing for tibial and femoral shaft fractures: Challenges and prospects in a Tertiary Health Care Facility in a resource constraint setting. Arch Int Surg 2016;6:96-9
Koval, Kenneth J.; Clapper, Mark F.; Brumback, Robert J.; Ellison, P. Stribling Jr.; Poka, Attila; Bathon, G. Howard; Burgess, Andrew R, Complications of Reamed Intramedullary Nailing of the Tibia. journal of orthopaedic trauma
FE Ogedegbe, OR Babalola, Outcome of Interlocking Intramedullary Nailing in the Treatment of Diaphyseal Tibial Fractures, Nigerian Journal of Orthopaedics and Trauma Vol 11, No 1 (2012)
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 The Nigerian Health Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The Journal is owned, published and copyrighted by the Nigerian Medical Association, River state Branch. The copyright of papers published are vested in the journal and the publisher. In line with our open access policy and the Creative Commons Attribution License policy authors are allowed to share their work with an acknowledgement of the work's authorship and initial publication in this journal.
This is an open access journal which means that all content is freely available without charge to the user or his/her institution. Users are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles in this journal without asking prior permission from the publisher or the author.
The use of general descriptive names, trade names, trademarks, and so forth in this publication, even if not specifically identified, does not imply that these names are not protected by the relevant laws and regulations. While the advice and information in this journal are believed to be true and accurate on the date of its going to press, neither the authors, the editors, nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.
TNHJ also supports open access archiving of articles published in the journal after three months of publication. Authors are permitted and encouraged to post their work online (e.g, in institutional repositories or on their website) within the stated period, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access). All requests for permission for open access archiving outside this period should be sent to the editor via email to editor@tnhjph.com.
