Analysis of proximal plating versus intramedullary nailing in the treatment of extra-articular proximal tibial fractures

Abstract

Extraarticular fractures of proximal tibia has been a challenging situation to most of the surgeons today. Treatment of these injuries is extremely challenging because of the inherent unstable fracture region, difficult reduction & fixation and severely compromised blood supply at the region. For the past decades, closed reduction and minimally invasive plating and intramedullary nailing have both become widely used treatment modalities for proximal and distal tibial metaphyseal fractures. This study was performed to compare the functional and radiological results of locking compression plateosteosynthesis over intramedullary nailing. This randomized prospective clinical study was conducted on 29 patients with a closed extra-articular fracture of the proximal tibia treated with minimally invasive percutaneous plate osteosynthesis (MIPPO) or intramedullary nailing by Tibia interlocking nail at a tertiary trauma center. Postoperative hospital stay, time to full weight-bearing, and union time were significantly less in the IMN group than in the PTP group, but there was no clear advantage of either technique in terms of operative time, infection rate, range of motion of the knee, or degrees of malunion and nonunion. Both implants have shown promising results in extra-articular proximal tibial fractures, and provide rigid fixation that prevents secondary fracture collapse.