Comparative study of minimally invasive plate osteosynthesis versus distal tip locking tibia nailing in treatment of distal 1/3 tibia shaft fractures

Abstract

Introduction: Distal 1/3 tibia shaft fractures pose a greater challenge to the surgeon due to its proximity to the ankle joint and due to lack of soft tissue protection. Choosing Modality of fixation in this fractures is quite difficult due to its proximity to ankle joint and less soft tissue coverage. Here this study tries to compare two most commonly used modalities that are tip locking nail and MIPO to find a better mode of fixation. Methods: There are 42 patients of fractures distal 1/3 tibia shaft fractures during a period of January 2016 and January 2017. They are randomly divided into two groups out of which 21 treated by tip locking nail and 21 patients by MIPO. Results: Out of 42 patients 21 (50%) treated by MIPO and 16 (50%) by tip locking nail. The mean age of the patient treated with the plate was 38.6 years. The mean age of patients treated by expert tibia nail is 39.18 years. 4 patients treated with MIPO had complications of superficial infections, ankle pain, implant failure. 7 patients operated by tip locking nail presented with knee pain, implant failure, malunion. Conclusion:Our study throws light on the tip locking nail as the effective method in lesser operative time, early mobilization of the patient and faster healing of fracture compared to MIPO. Even surgical wound infection rate was more common in MIPO than tip locking nail. But, anatomical reduction and proper fixation are achieved through MIPO than compared to tip locking nail.