A prospective comparative study on osteosynthesis of distal tibial metaphyseal fractures with plating V/s intramedullary nailing

Abstract

Background: Tibial fractures are the most common long bone fractures, while distal tibial fractures are even more complicated due to their proximity to the ankle and the close relationship with thin,Objectives: To assess and compare fractures' functional outcomes in Group A versus Group B. To assess the efficacy, advantages, and disadvantages of the treatment modalities and their complications. Materials and Methods: This is a comparative study done from October 2018 to March 2020 in the Department of Orthopaedics, Narayana Medical College, attached to Narayana general hospital, Nellore. In this study period total of 40 patients were taken for study as per inclusion criteria. The patients are randomized into two groups of 20 cases each. Group A treated with plating, and Group B was treated with intramedullary nailing. Results: In our study, the average duration for the radiological union in the intramedullary interlocking nail group was 20.1 ± 1.14 weeks and in the plating group, it was 24.1 ± 1.16 weeks. Thus, the union occurred significantly faster in the nailing group.3 patients from the plating group had delayed union. In this study, better ankle rom was noticed in the intramedullary interlocking nail group as compared to that of the distal tibia plating. Average dorsiflexion at the final follow-up was 12.8 degrees and 9.7 degrees in the intramedullary interlocking nail group and the distal tibia plating group.Conclusion: Intramedullary nailing has the advantages of shortened operating time, early weight-bearing decreased wound problems an early union of the fracture, decreased implant-related problems, and overall reduced morbidity.