A comparative study of intramedullary interlocking nailing and minimally invasive plate osteosynthesis in extraarticular distal tibia fractures

Abstract

Introduction: Distal tibial fractures are very commonly encountered by orthopaedic surgeons. They are one of the perplexing injuries encountered due to its poor blood supply and limited soft tissue cover. Our aim is to study and compare clinical and radiological outcome in extra articular fractures of distal tibia treated by IMILN and MIPPO locking compression plates with reference to rate of healing, functional outcome, and complications. Material and Methods: This was a prospective observational study, with a sample size of 30, 15 randomly assigned to MIPPO group and the remaining to the IM nailing group. The patients one year with clinical and radiological assessment. The data was then recorded in a semi-structured pro forma and entered in an MS Excel Spreadsheet. Statistical analysis was performed using SPSS v20. Results: Most of the population was over the age of 55 years for IMILN group, but younger in MIPPO i.e. 30-55 years. The most common mode of injury was RTA in both the study groups. 80% cases of IMILN had associated fibular fracture compared to 46.7% in the MIPPO group. Average time for fracture union was 5.4 months in IMILN group vs 65.3 months in the MIPPO group, which was not statistically significant. We observed fewer complications in terms of implant irritation, ankle stiffness and infection (superficial and deep) were seen in interlocking group as compared to plating group. Conclusion: MIPPO with a medial distal tibial locking plate and closed reduction with intramedullary nailing are equally viable options for management of extra-articular fractures of the distal tibia.