A Hospital Based Prospective Study to Assess the Outcome of the Trauma Patients with Tibia Fractures Treated with the Primary Fixation Using Rail Road System

Abstract

Background: The ideal treatment of high-energy tibial plateau fractures is controversial. LRS is a unilateral rail system consisting of Shanz pins, rail rods and sliding clamps. The aim of this study to assess the efficacy of outcome of the trauma patients with tibia fractures treated with primary fixation using rail road system. Materials & Methods: A hospital based prospective study was conducted in department of Orthopaedics, Vardhaman Mahavir Medical college, Safdarjung Hospital, Delhi, India. Total 40 patients having Modified Gustilo Anderson Type IIIA and IIIB9 were using rail road system to achieve bony union. Both male and female patients between the age of 18-60 years were included in the study. Bony and functional assessment was done by Association for the Study and Application of the Methods of Illizarov (ASAMI) criteria.10 Results: Our study showed that the patients were between 18-60 years of age with a mean age of 43.6± 4.30 years. A total of 35 patients were male and 5 patients were female and road traffic accident (75%) being the most common cause of injury. All patients achieved good range of movements in the follow-up period. Among 40 patients, bony results as per ASAMI score were excellent in 70% (n = 28), good in 25% (n = 10), fair in 2.5% (n = 1) and poor in 2.5% (n = 1). Functional results were excellent in 80% (n = 32), good in 15% (n = 6), fair in 5% (n = 2). Majority of patients 26 (65%) operated within 12 h in our study and Bone union time was 20.67 ± 5.32 weeks after injury. Conclusion: Primary fixation using rail road system is very versatile tool as primary and definitive management of compound tibia diaphyseal fracture due to its ease of application, strong fixation, early weight bearing and high chance of bony union.