European Journal of Cardiovascular Medicine

Background The frequency of open fractures is rising as high velocity injuries are on the rise in the current situation. Approximately 60–65% of all open fractures involve the tibia. The administration is challenging, time-consuming, and some people think it's raising morbidity. The current standard of care for open tibia fractures is wound debridement, external fixator placement, and delayed wound closure followed by internal fixation. Although the use of an external fixator is rapid, the patient's mobilisation and wound healing will be delayed as a result. Primary nailing is advantageous for open fractures Type I and Type II because there is less wound than in Type III. External fixation is the most common form of treatment for Type III a, b, and c. Materials and Methods A prospective study was done in department of Orthopedics, SVRR Government General Hospital, Tirupati from June 2022 to May 2023. The study was done in 25 patients who volunteered for the study with Gustilo Anderson Type IIIa open fracture of tibia who were treated with primary intramedullary interlocking nail fixation after wound debridement and skin grafting and skin release whenever needed. All the patients were surgically treated with in 24 hours from the time of fracture. Functional assessment is done by the Johner and Wruh criteria1. Radiological union assessment is done by RUST score (Radiological Union Scale in Tibia)2. All the patients were studied for the rate of infection. Results Of the 25 patients treated with primary nailing following debridement for Type IIIa tibia fractures, Johner and Wruh score of excellent in 12 patients(48%), good in 6 patients(24%), fair in 3 patients(12%) and poor in 4 patients(16%). RUST score of 9-12 is in 10 patients (40%), 5-8 in 12 patients (48%) and 4 in 3 patients (12%). Of all the 25 patients infection is seen in 4 patients (16%). Conclusion Primary nailing for Type IIIa tibia fractures gives good biomechanical stability and better wound coverage, and is advisable for early mobilization with good functional and radiological outcome and minimal complications.