title: Intramedullary nailing supplemented with Poller screws for proximal tibial fractures.
abstract: OBJECTIVE
  To evaluate outcome of intramedullary nailing supplemented with Poller screws for proximal tibial fractures using small diameter nails.
  
  
  METHODS
  50 men and 20 women (75 fractures) aged 18 to 65 (mean, 33) years underwent intramedullary nailing supplemented with Poller screws for acutely displaced fractures (n=60) or for delayed union (n=10) or mal-union (n=5) of the proximal metadiaphyseal tibia. 88% of the fractures were caused by road traffic accidents. 54 cases had closed fractures and 21 had grade I or II compound fractures. Clinical and radiological outcome was evaluated.
  
  
  RESULTS
  In 69 cases, healing occurred after a mean of 4.2 (range, 3-9) months. In 5 cases, there was non-union, which was resolved by bone grafting. One case was mal-united. 63 patients recovered a full range of knee motion (0º-130º), and the remaining 7 attained flexion of 0º to 90º. According to the knee rating scale of the Hospital for Special Surgery, outcome was excellent in 50 patients, good in 14, poor in 3, and failed in 3 at month 12, and remained so after a mean follow-up of 30.8 months. Postoperatively, 74 cases had <5º of varus or valgus malalignment, and only one developed varus of +7º. 65 cases exhibited no deformity, 7 had a deformity of <3º, and 3 had a deformity of 4º to 9º.
  
  
  CONCLUSIONS
  Poller screws help maintain fixation of intramedullary nailing and alignment of fractures.
authors.affiliation: Department of Orthopaedic Surgery, Swasthiyog Pratishthan Research Centre, Miraj, Maharashtra, India.
authors.forename: Sunil G
authors.initials: SG
authors.lastname: Kulkarni
authors.forename: Ankit
authors.initials: A
authors.lastname: Varshneya
authors.forename: Shreenath
authors.initials: S
authors.lastname: Kulkarni
authors.forename: Govind S
authors.initials: GS
authors.lastname: Kulkarni
authors.forename: Milind G
authors.initials: MG
authors.lastname: Kulkarni
authors.forename: Vidhisha S
authors.initials: VS
authors.lastname: Kulkarni
authors.forename: Ruta M
authors.initials: RM
authors.lastname: Kulkarni
mesh_terms: D000293:Adolescent; D000328:Adult; D001858:Bone Nails; D001863:Bone Screws; D004867:Equipment Design; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D017759:Fractures, Malunited / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult