Objective: Aim of current study was to determine the functional outcomes of closed static intramedullary nailing with distal two plane locking versus percutaneous MIPPO distal tibial locking plate in distal 3rd tibia metaphyseal fractures. Study Design: Randomized clinical trial Place and Duration: Nishtar Hospital Multan/Qaisrani Medical Center Multan. Jan 2021-March 2022 Methods: There were 76 patients of both genders with age 15-60 years presented. All the patients had 3rd tibia metaphyseal fracture were admitted to hospital for surgery. Following the collection of informed written consent from enrolled patients, complete demographic information was gathered. Patients were equally divided into two groups. Group I received intramedullary nailing with distal two plane locking and group II received percutaneous MIPPO distal locking plate. Favorable and unfavorable outcomes among enrolled cases were compared. SPSS 22.0 was used to analyze all data. Results: There were majority males 22 (60.5%) in group I and 20 (52.6%) in group II. In group I mean age was 30.8±6.42 years with mean BMI 24.71±3.19 kg/m2 and in group II mean age was 31.14±3.58 years and had mean BMI 25.7±7.17 kg/m2. Falling, accidents, sports and lifting of heavy object was the most common cause of fractures. We found that intramedullary nailing was more effective as compared to MIPPO distal locking plate in terms of functional outcomes but difference was insignificant. Frequency of complications were higher in group II found in 14 (36.8%) as compared to group I in 4 (10.4%) cases. Conclusion: We concluded in this study that distal third tibial metaphyseal fractures were effectively operated by intramedullary nailing distal two plane locking and MIPPO distal locking plate but frequency of complications were higher in MIPPO group as compared to intramedullary nailing. Keywords: Metaphyseal Fractures, MIPPO Distal Platting, Intramedullary Nailling, Functional Outcomes, Complications
Objective: The purpose of our study is to compare the safety and efficacy of MIPPO distal femoral locking plate versus retrograde nailing in distal locking plate fixation among patients suffering from distal femoral fractures. Study Design: Quasi Experimental study Place and Duration: Nishtar Hospital Multan. August 2021-May 2022 Methods: There were 112 patients of both genders with ages 15-48 years had distal femoral fractures and underwent for surgery were included in this study. After obtaining informed written consent, demographically detailed of enrolled cases were recorded. Causes of distal femoral fractures were assessed. Patients were equally categorized in two group. 56 patients in group O received MIPPO DFLP and in group P 56 cases received retrograde nailing. All patients were radiographed and categorized according on the criteria established by the AO/OTA categorization system.[13] Outcomes among both groups were assessed and compared in terms surgery duration, efficacy and complications. HSS score was used to describe effectiveness of both groups. SPSS 24.0 was used to analyze all data. Results: We found that males were higher in numbers 80 (71.4%) than females (32 (28.6%). Mean age of the included patients were 29.5±9.81 years and had mean BMI 24.8±11.44 kg/m2. Most common cause of fracture was road traffic accident (RTA) in 51 (45.5%) cases, followed by falling in 35 (31.3%) cases, sports in 17 (15.2%) cases and violence in 9 (8.04%). Most common affected side was right. As per AO classification, numbers were higher in Type 43A1 classification found in 65 (58.04%) cases. Mean union time in group O was lower 2.5±4.87 months as compared to group P 3.9±6.54 significantly with p value <0.005. We found significantly higher number of excellent results in MIPPO DFLP group found in 29 (51.8%) cases as compared to retrograde nailing group in 14 (25%) cases with p value <0.003. Complications (delayed union, non-union, deformity, bone stiffness) were found higher in group P. Conclusion: We concluded in this study that use of MIPPO DFLP for the treatment of distal third femoral shaft fractures is highly effective and useful as compared to retrograde nailing with p value <0.04 in terms of less unions time, higher excellent results and lower number of complications. Keywords: Retrograde Nailing, Distal Femoral Fractures, MIPPO DFLP, Efficacy, Complications
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