Comparative Study Between Intramedulary Interlock Nailing and Plating in Distal Metaphyseal Fractures of Tibia

Ravindra Hattarki,Sahil Bhagat

doi:10.4172/2161-1076.1000267

Abstract

Distal metaphyseal tibial fractures are unique. Fractures of distal tibia metaphysis occur typically as a result of axial and rotational forces on lower extremity and represents approximately 10% of the fractures of distal end of tibia. Objective: The present study aims to compare the functional outcomes of distal metaphyseal fractures of tibia with plating to that with reamed intramedullary nailing and complication arising with different modalities of fixation. Methodology:The study consist of 40 patients of distal metaphysical fracture of tibia consecutively treated in the period between Dec 2013 and Dec 2015 with either reamed intramedullary nailing or locked plating with open reduction method or minimally invasive techniques. Results: Mean age of patients was 41.3 years (range, 22-65) in group 1 and 39.45 years (range, 28-56) in group 2 (p = 0.558). The average time before union was 23.3 weeks (range, 16-36 weeks) in group 1 and 25.55 weeks (range,14-41 weeks) in group 2, (p = 0.299). Conclusion: Intramedullary nail being load sharing device, comparatively early mobilization can be started. Prolonged duration of protected weight bearing was required in patients treated with locked plate and screws.

Highlights

The location of fracture is close to ankle joint and is not uncommon for the fracture line to extend into the joint
The degree of associated soft tissue injury is higher in distal metaphyseal fractures than with shaft fractures [3]
The present study aims to compare the functional outcomes of distal metaphyseal fractures of tibia managed with plating to that with reamed intramedullary nailing complication rates arising with different modalities of fixation

Summary

Introduction

Distal third of the tibia has less muscle coverage in comparison to the rest of tibia. Often this fracture are communited and unstable. They can be associated with severe open or closed soft tissue injury. The degree of associated soft tissue injury is higher in distal metaphyseal fractures than with shaft fractures [3]. The management of these distal injuries is often more complex than the treatment of tibial diaphyseal fractures, leading to potential for postoperative complications and poor outcome [4,5]

Methods

Results

Conclusion