Functional Outcome of Management by Intramedullary Interlocking Nailing for Extra-Articular Distal Tibial Fractures in Adults.

Abstract

Extra-articular distal tibial fractures (EADTFs) are commonly associated with fibular fractures in approximately 85% of cases and present unique challenges due to their unstable nature and propensity for complications such as malunion, delayed union, non-union, and soft tissue compromise. This study aimed to evaluate the functional and radiological outcomes of intramedullary interlocking nailing (IMN) in the management of EADTFs. This prospective observational study was conducted on 30 patients diagnosed with extra-articular distal tibial fractures, who underwent intramedullary nailing at a tertiary care center. Radiographic assessments included time to union, loss of reduction, and angular malalignment. Diagnostic criteria for consistent bony union, non-union, delayed union, and malunion were applied. Functional outcomes were measured using the American Orthopaedic Foot and Ankle Society (AOFAS) scoring system during follow-up evaluations. Of the 30 patients included, the mean age was 41.6 ± 15.6 years, with a male predominance (73.3%). Based on the AOFAS score, 26.7% of patients achieved an excellent outcome, 56.7% had good outcomes, and 16.6% had fair outcomes. No patient recorded a poor outcome. Radiologically, the mean time to union was 18.5 ± 2.2 weeks. Malunion occurred in 6.7% of cases, while there were no instances of delayed union, non-union, or infection reported. Intramedullary interlocking nailing is a reliable and effective treatment modality for extra-articular distal tibial fractures, offering favorable functional outcomes and a low complication rate. The technique demonstrates consistent union rates and minimal risk of infection or non-union, reinforcing its role as a preferred management strategy in appropriately selected cases.