Outcome of Proximal Tibial Fracture among Patients Treated with Intramedullary Nail Supplemented with Poller Screw: A Descriptive Cross-sectional Study

Abstract

Introduction: It is difficult to achieve and maintain reduction during intramedullary nailing of meta-diaphyseal tibia fractures with short proximal fragments. The use of a poller screw helps to achieve and maintain reduction as it acts as the third point of fixation. This study aimed to evluate the outcome of proximal tibial fracture among patients treated with intramedullary nail supplemented with poller screw.

Methods: This descriptive cross-sectional study was done in a tertiary care centre among patients treated with intramedullary nail supplemented with poller screw from 01 November 2021 to 30 December 2022 after receiving ethical approval from the Institutional Review Board. Patients with acute fractures, delayed union, or nonunion of the proximal tibia at the meta-diaphyseal region were included in the study. Convenience sampling technique was used. Radiological outcome was measured by varus/valgus angulation and antero–posterior angulation, while functional outcome was measured by Rasmussen’s knee scoring.

Results: Among 41 patients, 30 (73.17%) had acute fractures, 6 (14.63%) had delayed union, and 5 (12.20%) had non-union. One poller screw was used in 28 (68.29%) cases and two poller screws were used in 13 (31.71%) cases. At final follow-up, there were 5 (12.20%) cases of malunion. A majority, 37 (90.24%) patients, had excellent final Rasmussen’s knee grading.

Conclusions: The use of poller screw in fractures of meta-diaphyseal region of proximal tibia had similar outcome when compared with previous studies.