Comparative Study Between Intramedulary Interlock Nailing and Plating in Distal Metaphyseal Fractures of Tibia

Abstract

Distal metaphyseal tibial fractures are unique. Fractures of distal tibia metaphysis occur typically as a result of axial and rotational forces on lower extremity and represents approximately 10% of the fractures of distal end of tibia. Objective: The present study aims to compare the functional outcomes of distal metaphyseal fractures of tibia with plating to that with reamed intramedullary nailing and complication arising with different modalities of fixation. Methodology:The study consist of 40 patients of distal metaphysical fracture of tibia consecutively treated in the period between Dec 2013 and Dec 2015 with either reamed intramedullary nailing or locked plating with open reduction method or minimally invasive techniques. Results: Mean age of patients was 41.3 years (range, 22-65) in group 1 and 39.45 years (range, 28-56) in group 2 (p = 0.558). The average time before union was 23.3 weeks (range, 16-36 weeks) in group 1 and 25.55 weeks (range,14-41 weeks) in group 2, (p = 0.299). Conclusion: Intramedullary nail being load sharing device, comparatively early mobilization can be started. Prolonged duration of protected weight bearing was required in patients treated with locked plate and screws.

Comparision of functional and radiological outcomes in extraarticular fractures distal third tibia treated with intramedullary nailing or plating

“…The disadvantages include technical difficulties due to anatomy of distal metaphyseal flare, proximity of the fracture to the ankle joint, and distal nail fixation. The medullary canal is hourglass shaped, and the nail fits only in mid-diaphysis and not in distal segment [10] . The advantages of MIPPO is it reduces the surgical soft tissue injury while preserving bone vascularity and fracture hematoma.…”