Innovative distal bolt-locking screw tibial nailing method and conventional nailing: A comparison of outcomes

Objectives: Distal bolt-locking screw (DSBLS) tibial nailing offers an innovative method in which the nail is locked upon entering the screw. The current study compares the clinical, radiological, and functional outcomes of DSBLS tibial nails with conventional tibial nails. Patients and Methods: We retrospectively evaluated 38 tibial fractures of 37 patients treated with intramedullary nailing. In Group 1, 21 fractures were treated with DSBLS nailing, while in Group 2, 17 fractures were treated with conventional nailing. Duration of surgery, time to weight-bearing, time to union, presence of deformity, return to work and sports, complications, American Orthopedic Foot and Ankle Society Score (AOFAS) and Olerud-Molander Ankle Score (OMAS) values were compared between the groups. Results: Group 1 patients had significantly shorter time to full weight-bearing than patients in Group 2 (P=0.032). There was no significant difference between the groups in functional comparisons according to the AOFAS. In contrast, the outcomes of Group 2 were better than those of Group 1 according to the OMAS (P=0.475 and P=0.037). The outcomes for the other variables were similar. Conclusion: In this method, patients can bear weight in a shorter time. The results of DSBLS nailing are as good as conventional nails, and it can be safely preferred in treating tibial fractures with intramedullary nailing.