الفهرس 
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Abstract
This study included forty patients admitted to El-Hadara University Hospital from June 2012 to June 2013 suffering from closed tibial mid-shaft fractures. They were divided alternatively into two groups, group I with closed reduction and plaster cast and group II with closed reduction and interlocking nailing.
On admission, all patients were assessed by history taking, clinical examination, and radiological assessment.
In group I, the youngest patient was sixteen years old and the oldest was sixty nine years old with a mean of 35.5 years. There was 19 males and 1 female. Eight patients(40%) with right side involvement and twelve patients(60%) with left side fractures. Thirteen patients(65%) had simple fractures, four patients(20%) had wedge fractures and three patients(15%) with comminuted fractures. Eleven patients(55%) were due to direct trauma, five patients(25%) due to RTA, three patients(15%) due to falling down and only one patient(5%) due to FFH.
In group II, the youngest patient was seventeen years old and the oldest was sixty six years old with a mean of 35.5 years. There was 18 males and 2 female. Nine patients(45%) with right side involvement and eleven patients(55%) with left side fractures. Ten patients(50%) had simple fractures, five patients(25%) had wedge fractures and five patients(25%) with comminuted fractures. Eight patients(40%) were due to direct trauma, eight patients(40%) due to RTA, three patients(15%) due to falling down and only one patient(5%) due to FFH.
All patients received analgesics, anti-edematous measures and anticoagulants pre- and post-operatively with an above knee slab.
Only for group II antibiotics were prescribed preoperatively at the time of induction and for 48 hours postoperatively.
In group I, the fracture was reduced by manipulation under anaesthia and above knee plaster cast was applied. After 6-8 weeks with x-rays showing early callus formation the cast was exchanged for Sarmiento cast for another 6 weeks, now the patient is encouraged to be out of bed and to bear weight as tolerated using crutches. Usually, full unsupported weight bearing is achieved after 12-16 weeks.
In group II, the limb was prepared and draped before closed reduction. The fracture was reduced then it was fixed by an intramedullary interlocking nail. Sutures were removed after 2 weeks and partial weight bearing was begun but in cases of multifragmented fractures the weight bearing was delayed according to signs of union. Full range of motion of knee and ankle joints should be started as tolerated immediately post-operatively.
The patients were followed up for a period of nine months.
The final results according to the