Role of Primary Intramedullary Interlocking Nail in Compound Gustilo-IIIA Tibia Fracture in Developing World. -

Objective: The decision of internal fixation in Gustilo's Type IIIA becomes a formidable challenge in patients reaching late. The purpose of the present study was to find out results of intramedullary interlocking nailing in these patients. Materials and Methods: Twenty five compound IIIA fractures, which were internally fixed within 24h after injury, were included in the present analysis. Follow-up ranged from 12 to24 months. Mean follow-up was 18 months. Result: Superficial infection was found in 12 patients and deep infection was found in 6 patients. Non-union was found in 2 cases. Functional evaluation using Katenjian's criteria showed 60% (15) fractures have good to excellent results. Conclusion: Up gradation of the infrastructure is needed in the developing country to obtain satisfactory results of interlocking nailing in Gustilo's Type IIIA fracture tibia in emergency department, strict protocol such as aggressive debridement, prophylactic antibiotic coverage, and timely bone grafting is utmost importance in dealing these fractures. The primary coverage of the wound is discouraged.

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