الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
from the present study the following can be concluded:
• Partial weight bearing was earlier when tibial fractures were
treated by interlocking nail than when treated by biological
plate.
• Full weight bearing and union were earlier when treated by
interlocking nail than biological plate.
• The use of interlocking nail in the treatment of proximal and
distal tibial fractures can be extended, however percutaneous
plating has advantages in the management of proximal & distal
tibial fractures that are not amenable to intramedullary nail
fixation either because of the proximal or distal nature of the
fracture not allowing locking screw placement, intraarticular
extension of the fracture or concern about varus or valgus
malalignment.
• The skin incision should be placed away from the area involved
in kneeling, particularly in patients who have to kneel daily
because of the nature of their work.
• Injury to the patellar tendon, fat pad and gliding tissues should
be avoided by the delicate use of the instruments and by
employing tissue protectors.
• Fine handling to decrease the trauma during insersion of the
interlocking nail to decrease the postoperative knee pain.
• Protrusion of the nail should be avoided. The implant should be
adequately countersunk and the appropriate design chosen
regarding its position of the locking screws.
• The length of the locking screws must be carefully checked to
avoid protrusion and irritation of the soft tissues.
Conclusion& Recommendations
• Flexion of the knee to an angle greater than 100 during nail
insertion should give minimum contact between the introducer
and the patella, making pressure changes at the patellofemoral
joint less likely.