title: Determinants of re-operation following tibia intramedullary nailing at a tertiary hospital in south-west Nigeria.
abstract: BACKGROUND
  intramedullary nailing is a method of choice in the management of long bone diaphyseal fractures. However, complications necessitating re-operation may arise. This study was aimed at determining the rate and indications for re-operation following intramedullary nailing of tibia shaft fractures.
  
  
  METHODS
  it was a cross-sectional study done at Orthopaedic Department of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife in Southwest Nigeria. Records of patients who had interlocking nailing for tibia shaft fracture between 2005 and March 2013 were retrieved. Variables of interest extracted included aetiology of fracture, type of fracture, cadre of surgeon and indication for re-operation. Frequency distribution and chi-square analysis were done using SPSS version 22. Level of statistical significance was determined at p-value <0.05.
  
  
  RESULTS
  One hundred and forty-six patients had tibia nailing done during the study period. Eighty-six patients met the study criteria with male to female ratio of 2.6:1. There were 51 (59.3%) with open fractures and 35 (40.7%) with closed fractures. Ten patients had re-operation giving a re-operation rate of 11.6 %. Two most common indications for re-operation included loose screw 3 (25%) and surgical site infection (SSI) 3 (25%). There was no statistically significant association between rate of re-operation and the cadre of surgeon (p=0.741) and type of fracture whether closed or open (p=0.190).
  
  
  CONCLUSIONS
  Re-operation following tibia intramedullary nailing is an ever present risk. Precautions should be taken to prevent the common indications such as loose screw and surgical site infections.
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Obafemi Awolowo University/Teaching Hospitals Complex, Ile Ife, Nigeria.
authors.forename: Oluwadare
authors.initials: O
authors.lastname: Esan
authors.affiliation: National Orthopaedic Hospital, Igbobi, Lagos, Nigeria.
authors.forename: Adetunji Mapaderun
authors.initials: AM
authors.lastname: Toluse
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Obafemi Awolowo University/Teaching Hospitals Complex, Ile Ife, Nigeria.
authors.forename: Oludare Uriel
authors.initials: OU
authors.lastname: Ashaolu
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Obafemi Awolowo University/Teaching Hospitals Complex, Ile Ife, Nigeria.
authors.forename: Ayodele Elkanah
authors.initials: AE
authors.lastname: Orimolade
mesh_terms: D001858:Bone Nails; D003430:Cross-Sectional Studies; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D005596:Fractures, Closed / Q000601:surgery; D005597:Fractures, Open / Q000601:surgery; D006801:Humans; D008297:Male; D009549:Nigeria; D012086:Reoperation / Q000706:statistics & numerical data*; D013530:Surgical Wound Infection / Q000453:epidemiology; D062606:Tertiary Care Centers; D013978:Tibial Fractures / Q000601:surgery*
keywords: Reoperation rate; intramedullary nailing; tibia fractures