Comparision of functional and radiological outcomes in extraarticular fractures distal third tibia treated with intramedullary nailing or plating

Abstract

Introduction: Tibial fractures are most common long bone fractures, while distal fractures are even more complicated due to its proximity to ankle, and with close relationship with thin soft tissue envelope and severe comminution. Distal tibial extraarticular fractures are a common consequence due to road traffic accidents or other high energy injuries. AIM: To compare functional and radiological outcomes in extra articular distal third tibia fractures, treated with intramedullary nailing or plating. Material and Method: Study comprised of 40 patients of distal tibia fracture without articular involvement, admitted in Geetanjali Medical College and Hospital, Udaipur, Rajasthan. After primary management of fracture stabilisation. patients were randomly selected for surgical fixation either with IMN or MIPPO plating. 20 patients were included from each study group. Result: All the patients treated with either surgical modality were compared for time of fracture union, ROM at ankle joint, early weight bearing, non-union and malunion. ROM at ankle joint was assessed with AOFAS ankle score. The mean fracture union time for IMN was 4.5 month, whereas in plating group it was 6.5 month. Immediate weight bearing was advised for IMN group, while weight bearing was delayed for at least 6 weeks in plating group. AOFAS ankle score for the nailing group was 92.05 (EXCELLENT) while for plating group was 89.10 (GOOD). The difference between two score was found to be significant (p value =0.05). Conclusion:Both the treatment modalities were equally good for treatment of distal tibia extra articular fractures, but IMN was better in terms of early weight bearing, early fracture union with excellent ankle score as compared to MIPPO plating.