Descriptive Study of Tibia Shaft Fracture Treatment with Intramedullary (SIGN) Nail in Wazir Mohammad Hospital from March 2023 to September 2024
Abstract
Tibial shaft fractures are among the most common and disabling long-bone injuries encountered in orthopedic practice due to the subcutaneous location and weight-bearing nature of the tibia. This descriptive case-series study evaluated 70 patients with closed or Gustilo–Anderson Type I/II open tibial shaft fractures treated with Surgical Implant Generation Network (SIGN) intramedullary nails at Wazir Mohammad Akbar Khan Hospital between March 21, 2023, and September 21, 2024. In total, 196,931 patients attended the hospital, with 17,471 admitted to the Orthopedics and Traumatology Department, from which 70 consecutive eligible cases were enrolled. Data on patient demographics, fracture mechanisms, treatment outcomes, complications, and follow-up were retrieved from admission registers and analyzed using Microsoft Excel. Results revealed that the majority of patients belonged to the 16–25-year age group (n=30, 42.86%), and males comprised 55 cases (78.57%). Laborers formed the largest occupational category (n=25, 35.71%), and 40 patients (57.14%) resided in Kabul city. Falls were the predominant injury mechanism (n=30, 42.86%), followed by road traffic accidents (n=25, 35.71%), plate fixation failure (n=10, 14.29%), and external fixation failure (n=5, 7.14%). Regarding clinical outcomes, 40 patients (57.14%) achieved an excellent result, 20 (28.57%) had a good outcome, and 10 (14.29%) had a poor outcome. Postoperative complications were absent in 50 cases (71.43%), whereas infection occurred in 15 cases (21.43%) and nonunion in 5 cases (7.14%). Follow-up at 6 weeks was attended by 30 patients (42.86%), 20 patients (28.57%) were evaluated at 12 weeks, and 20 patients (28.57%) had no follow-up recorded. In conclusion, SIGN intramedullary nailing demonstrated favorable therapeutic outcomes and low complication rates for tibial diaphyseal fractures in young active males. Standardized postoperative follow-up systems and occupational injury prevention strategies remain essential to optimize long-term clinical recovery
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