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SAS Journal of Surgery | Volume-12 | Issue-01
Treatment of Neglected Tibial Fractures Using Locked Intramedullary Nailing in a Precarious Setting without Image Intensification. Experience at Brazzaville University Hospital. About 84 Cases
E. M. Radam, K. E. N. Vilma, I. S. Y. Paul, N. M. Fabrice, Z. F. Z. Pentèce, M. B. Tassy, N. G. M. Nevil Stève, M. P. Regis, Bouhelo-Pam Kevin Parfait Bienvenu, G. Leyono-Mawandza Peggy Dahlia
Published: Jan. 9, 2026 |
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70
Pages: 9-15
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Abstract
Introduction: Leg fractures, especially tibial fractures, are a major public health problem linked to road accidents, affecting working-age people. They are often open and complex (soft tissue, infection), with locked intramedullary nailing (LIMN) as the standard treatment, but limited by the lack of equipment (fluoroscope) in poor countries where external fixators are sometimes preferred for managing open fractures, despite frequent infectious complications. Patients and Methods: This was a retrospective, single-centre descriptive study of 84 cases in the orthopaedic and trauma department of Brazzaville University Hospital. It involved analysing the records of patients with neglected tibial fractures that had developed into malunions and who underwent locked intramedullary nailing surgery between June 2022 and July 2025 and who were operated on for neglected leg fractures (open or closed) that had been neglected and treated between the 2nd and 6th month following their trauma. Results: 84 cases (approximately 24.35%) were hospitalised and treated between the 2nd and 6th month after the trauma. The average age was 38 years +/- 20, with extremes ranging from 20 to 70 years. The majority (82.14%) of patients resided in the department of Brazzaville. Road accidents were the main cause in 75 cases (89.28%), followed by falls in the context of accidents at work in 3 cases (3.57%), and sports or domestic accidents in 6 cases (7.14%). Our study found 62 cases (73.80%) of closed fractures, including 21 cases (25%) of tibia-fibula fractures, 12 cases (14.28%) of isolated tibia fractures, 18 cases (21.42%) of middle third fractures and 11 cases (13.09%) of fractures of the lower third), compared with 22 cases (26.19%) of open fractures, including 17 cases (20.23%) of fractures of the middle third and 5 cases (5.95%) of isolated tibial fractures. Conclusion: Tibial fractures are common and severe injuries, often caused by road accidents, with significant consequences and compl