A comparative study of functional outcome of distal tibial extra-articular fracture fixed with intramedullary interlocking nail versus locking compression plate

Abstract

Background: Distal metaphysical fracture of the tibia has been a challenging situation when mostly treated with Plaster of Paris casts, resulting in ankle and knee stiffness and prolonged immobilization. This affecting quality of life of the patient. For the past decade, nailing and plating for fracture reduction has been successful in treating fractures of lower extremity especially distal tibia Objectives: To compare the functional and radiological results of locking compression plate osteosynthesis over intramedullary nailing. Methods: Patients with closed extra articular distal tibial fractures admitted under orthopedics in KIMS hospital will be randomly divided into 2 groups of 10 patients each. Group-1 was operated by Closed reduction and internal fixation with Intramedullary interlocking nail and Group-2 was operated by Locking compression plate done using MIPPO technique. Patients was followed up at regular intervals of 6 weeks for 6 to 10 months and assessed clinically, functionally and radiologically based in IOWA knee evaluation and ankle evaluation rating system. Conclusion: All fractures united well. Rate of union in patients who underwent plate fixation with LCP had lesser average union time (26 weeks) compared to IMIL nailing (27 weeks). In our study valgus union of >5degrees in two patients and varus union of >5 degrees in two patient in IMIL nail group. But in plating group no malunion was noted. In both groups we achieved good anatomical reduction, stable internal fixation and early mobilization and functional outcome in both groups are comparable with statistically significant difference.