الفهرس 
Introduction and Aim of the workOnly 14 pages are availabe for public view
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Abstract
Fracture involving the proximal and distal third tibia is one of the most common problems facing orthopedic surgeons .This fracture is treated by plate, external fixator or intramedullary nailing. Due to the complication of plate and external fixator, so there is increased scope for indication of intramedullary nailing in the treatment of proximal and distal third tibial fractures.
Due to anatomy of the tibia, there are some deformities that occur after nailing of proximal and distal third tibia. To avoid these complications during intramedullary nailing of tibia, we used cortical or cancellous screws as blocking ”poller” screws.
The aim of the work was to study the results of treatment of fractures of proximal and distal third tibia by interlocking intramedullary nailing with blocking screws.
Twenty patients with 20 tibial shaft fractures (proximal and distal third) were studied in Beni-Suef University Hospital in this study.
Males were affected more than females. The age of patients ranged from 22 to 63 years with an average of 35.50 years. Road traffic accidents were the commonest cause of injury. 4 cases were in the proximal third tibia and 16 cases were in the distal third tibia. The left side was affected in (55%) of cases, while the right side was affected in (45%) of cases. 14 cases were recent and 6 cases were old. One poller screw used in 19 cases and two poller screws used in one case.
6 cases only need small incision to do the reduction. The mean age of union was 5.1 months. Partial weight bearing were advised after 6 weeks after operation. The main complication was superficial infection which could be controlled by antibiotics, mild pain and intermittent swelling relieved by time.
The results of treatment were assessed by system of Ekland et al. Full planter and dorsiflexion of ankle were showen in 90% of patients. Shortening < 2 cm was observed in one patient (5%). One patient showed extension lag> 15o. One patient showed anterior angulation 7o. Varus angulation 5o in 4 patients.
The overall results were satisfactory in 17 cases (85%) and unsatisfactory in 3 cases (15%).
We recommend that this method could be used in the management of proximal and distal tibial fractures. The procedure requires careful preoperative planning for the initial deformity and the site of placement of the blocking screws. Careful follow up of the patients is recommended. This technique confirmed by our results minimizes the complication rate of malalignment and facilitates early return to normal activities of the patient.