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Mechanical Effect of Poller Screw in Metaphyseal Fractures of Tibia Fixed by Locking Intra-Medullary Nail

M.Sc.; Mohamed A. Omar Moaaz Abd El-Monaem, M.D. Hany A. Soliman
The Medical Journal of Cairo University , Volume 88, pp 1839-1848; doi:10.21608/mjcu.2020.118541

Abstract: Background: Intramedullary nailing of metaphyseal frac-tures may be associated with deformity as a result instability after fixation. Our aim was to evaluate the clinical use of Poller screws (blocking screws) as a supplement to stability after fixation with statically locked intramedullary nails of small diameter. Aim of Study: To evaluate the mechanical effect and clinical outcome of poller screw in metaphyseal fractures of tibia fixed by locking intramedullary nail. Patients and Methods: 15 men and 5 women (20 fractures) aged 19 to 60 (mean, 36.25) years underwent fixation of tibial metaphysis by locking intramedullary nail and poller screw. The mechanisms of injury included motor car accident in thirteen patients, fall from height in two patients, direct trauma in five patients. Radiological and clinical outcome was eval-uated. Results: Twenty patients were followed-up in the outpatient clinic for assessment of fracture healing or the establishment of a nonunion. Union was defined as the healing of at least 3 of 4 cortices on a biplanar radiograph. All the twenty patients (100%) achieved union at average time twenty weeks (ranging from 16 to 24 weeks). Conclusion: Poller (blocking) screws are an important adjunct for intramedullary nailing; aiding fracture reduction at the metaphysis, and offsetting deforming forces that cause malalignment.
Keywords: fractures / healing / blocking / Screws / Intramedullary Nail / Nailing / Poller Screw

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