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How To Fix Tibia Without C Arm

Author: 
Narinder Sharma, Mohinder Singh Chib and Anita Sharma
Subject Area: 
Health Sciences
Abstract: 

Tibia fracture constitutes one of major orthopedic burden. Among all tibia fractures closed fractures constitutes more than >50% cases. The study is done to assess the results of treatment of tibia fracture without c-arm radiation exposure. The idea is to overcome the slowly eroding disease of DEPENDENCY ON C-ARM. Methods: The study involves prospective analysis of 136 patients with 150 tibia fractures with age between 18 to 60 treated between May 2016 to may 2017. The study includes only extra-articular and closed type of injury with fracture pattern varying from transverse to comminute in appearance. The study is mainly based on intraoperative reference markers of reduction being Tibia Shin, plumb line fron tibial tuberosity to 2nd metatarsal, and relative position of foot in respect to leg. The postoperative analysis was done in all patients radiologically and functionally. Results: About 150 cases are being studied with closed interlocking nailing done in 120 case and biological plating with MIPPO in 30 cases. Postoperative acceptability in our study include <5 degree valgus/varus/rotational deformity. Among 120 cases with nailing done, 114 patients are managed well with 6 cases shows failure of technique with not able to perform locking of nail without use of c-arm due to excessive hammering of nail and subsequent rotation of nail. Among all 114 case the postoperative results are within the acceptability criteria planned. Among 30 cases with proximal and distal extra-articular tibia fracture and Biological plating attempted using MIPPO technique performed well with no failure seen in any respect and all following the acceptability criteria planned as per study. Conclusion: The study shows that with the use of reference markers like Tibia Shin, plumb line fron tibial tuberosity to 2nd metatarsal, and relative position of foot in respect to leg. Reduction can be achieved in majority of cases within acceptable range. The technique has much role in centres with limited facilities of intraoperative radiography as the study is being also conducted in place where there is nonavailability of c-arm on emergency basis.

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