A comparative study of intra-medullary interlocking nailing versus locking compression plating in tibial diaphyseal fractures

Abstract

Background: Tibia is the most commonly fractured long bone in the body and treating the tibial fractures continues to be controversial. In this study we aim to treat the tibial diaphyseal fractures giving them a stable construct which allows early weight bearing with minimal complications. Material and Methods: In this study we have taken 50 patients with diaphyseal tibia fractures of which 25 are treated with Intramedullary Interlocking nail and the remaining 25 are treated with Tibia locking compression plate. Our study was a comparative and prospective study. We have compared the outcomes in various aspects including the union time, time to mobilisation and post op complications. The functional outcome at one year were measured and compared. Results: All the 50 patients are in the age range of 20 -70 years. We have identified road traffic accidents (which accounted up to 65%) to be the most common mode of trauma besides the domestic accidents (Which accounted up to 35%). The rate of union is high in patients treated with nailing than the patients treated with plating. The average time for union in patients treated with nailing was 16 weeks (16-22 weeks) when compared to patients treated with plating which was 24 weeks (22-30 weeks), (p=0.001). The time for mobilisation is significantly less in patients treated with nailing when compared to patients treated with plating (p=0.001). The rate of union is high in patients treated with nailing than the patients treated with plating. Post-operative complications such as infection was found to be of high incidence in patients treated with plating. However, 4 % patients treated with nailing was found to have mal-alignment. The functional score in patients treated with nailing was found to be better than those treated with plating. Conclusion: We conclude that intra-medullary interlocking nail is a reliable and satisfactory method for the treatment of diaphyseal tibia fractures with high union rates, good functional outcome and low complications.