Functional Outcome of Management by Intramedullary Interlocking Nailing for Extra-Articular Distal Tibial Fractures in Adults.

Objectives: Extra-articular distal tibial fractures (EADTFs) are commonly associated with fibular fractures in approximately 85% of cases and present unique challenges due to their unstable nature and propensity for complications such as malunion, delayed union, non-union, and soft tissue compromise. This study aimed to evaluate the functional and radiological outcomes of intramedullary interlocking nailing (IMN) in the management of EADTFs. Methods: This prospective observational study was conducted on 30 patients diagnosed with extra-articular distal tibial fractures, who underwent intramedullary nailing at a tertiary care center. Radiographic assessments included time to union, loss of reduction, and angular malalignment. Diagnostic criteria for consistent bony union, non-union, delayed union, and malunion were applied. Functional outcomes were measured using the American Orthopaedic Foot and Ankle Society (AOFAS) scoring system during follow-up evaluations. Results: Of the 30 patients included, the mean age was 41.6 ± 15.6 years, with a male predominance (73.3%). Based on the AOFAS score, 26.7% of patients achieved an excellent outcome, 56.7% had good outcomes, and 16.6% had fair outcomes. No patient recorded a poor outcome. Radiologically, the mean time to union was 18.5 ± 2.2 weeks. Malunion occurred in 6.7% of cases, while there were no instances of delayed union, non-union, or infection reported. Conclusion: Intramedullary interlocking nailing is a reliable and effective treatment modality for extra-articular distal tibial fractures, offering favorable functional outcomes and a low complication rate. The technique demonstrates consistent union rates and minimal risk of infection or non-union, reinforcing its role as a preferred management strategy in appropriately selected cases.