الفهرس 
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Abstract
In the present study which was carried out in Sohag university hospitals, faculty of medicine, Sohag university from January 2017 to August 2018.
Thirty patients with comminuted tibial shaft fractures were included.
In our study we aimed to evaluate whether these theoretical advantages could be proved in practice by evaluation of the results of internal fixation for these types of fractures by IMN (interlocking tibial nail) and\or plates and screws(MIPO).
The management of comminuted tibial shaft fractures has always been a challenge to the surgeon. The traditional surgical techniques aiming at anatomical reduction and rigid internal fixation has raised a lot of complications, probably due to soft tissues status, comminution and devitalization of the fracture fragments that renders healing markedly jeopardized.
The introduction of the concept of internal fixation aims to improve the chances of healing as it utilizes the importance of the soft tissue envelope and preserves the vitality of the involved bony segments.
Out of the 30 fractures managed by this method 24 fractures showed uncomplicated healing within a reasonable period of time. The complication rate was considered minimal. Only one case of non-union, two cases of delayed infection and 4 patients of malunion in valgus or varus malalignment, however we passed through a learning curve during performing this study, with most of the complications occurring in the early cases.
We recommend that this method could be used in the management of comminuted tibial shaft fractures.
The procedure however is technically demanding, requiring the availability of appropriate tools and surgical implants, Careful follow up of the patients is recommended. This technique confirmed by our results minimizes the complication rate and facilitates early return to normal activities of the patient. Achieving a good quality reduction at the level of the bone segment should be the objective for anatomical axis restoration.