الفهرس 
? Anatomy Of The LegOnly 14 pages are availabe for public view
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Abstract
Intramedullary nailing is considerd a safe and effective method for the treatment of most tibial fractures. It provides stable fixation with minimal violation of the soft tissue envelope. The introduction of interlocking tibial nails has extended the indications of intramedullary fixation, to include extra-articular fractures of the proximal and distal third tibial fractures. Patients with these fractures treated with intramedullary nails have a high incidence with angular malalignment. Valgus and apex anterior malalignment and anterior displacement of the proximal fragment are the most common deformities with fractures of proximal third of tibia. Varus and valgus deformities occurs with fractures of the distal third tibial fractures. To overcome these problems and improve outcome, certain modifications to the standard operative technique have been proposed, such as the use of additional buttress plate different patient positioning, extended parapateller or retropateller approaches and the use of blocking screws. Blocking screws are effective to help obtain and maintain alignment of fractures of the proximal and distal third of the tibial shaft treated with intramedullary nails. The indications for this technique may be extended to other long bone fractures in which angular deformity can complicate intramedullary nail insertion. In this study we evaluated the treatment of the proximal and distal third fractures of the tibia by intramedullary nailing and blocking screws to prevent malalignment that may occur in these fractures. Out of the 20 fractures managed by this method 19 fractures showed uncomplicated healing within a reasonable period of time. The complication rate was considered minimal. Only one patient had a new fracture line at the site of insertion of a blocking screw and three cases of residiual malalignment of less than 5°.