Introduction: Nonarticular proximal‐third fractures occur because of a variety of mechanisms and account for 5% to 11% of tibial fractures. Treatment is challenging and the rates of compartment syndrome and arterial injury are higher, especially for displaced fractures. Materials and method: This is a prospective interventional study included 48 patients aged 21 to 68 years and were diagnosed as having a proximal tibial fracture with or without diaphyseal involvement. The fractures were stabilized with closed reduction and internal fixation with expert tibia nail of appropriate sizes at a tertiary trauma care centre from January 2019 to July 2020. Result: Out of 48 patient 40 patient had no extension lag only 8 patient had extension lag more than 10 degree who had showed poor compliance to pain and physiotherapy Other than infection other complication included, delayed union (3) varus deformity(0), post traumatic arthritis in 2 patients. No complications like Compartment syndrome, DVT, Iatrogenic foot drop and Avascular necrosis. Out of 48 patients 22 patient had radiological union at 12 weeks with average time for union was 16 weeks. Majority of our patients 80% started walking without support in 18-20 weeks. Discussion: Proximal tibia plays a crucial role in weight transmission via knee joint and is vital in knee joint mobility and function. Fractures in this region lead to significant morbidity and decreased quality of life, and are difficult to treat owing to subcutaneous anteromedial surface with high incidence of open fractures. Conclusion: Management of extra articular proximal tibia fractures is technically challenging to manage due to subcutaneous bone anteromedially and poor soft tissue conditions and hence involves various postoperative complications. The low rates of delayed union, malalignment, and implant-related complications from our study suggest that use of the ETN (expert tibia nail) can result in equal or better outcomes than those reported following use of existing tibial intramedullary nail designs for fractures between and including the proximal metaphysis.
Neetin Prahlad Mahajan, Tushar Patil, Jayesh Mhatre, Kevin Jain, Pramod Bagimani, Jayesh Mhatre. A study for assessment of functional outcome after surgical management of extra articular proximal tibia fractures using xpert tibia nail and review of literature. International Journal of Orthopaedics Research, Volume 4, Issue 1, 2022, Pages 38-44