Comparison of Plating Versus Intramedullary Nailing for the Treatment of Distal Tibial Metaphyseal Fractures: A Longitudinal Study

Abstract

Aim: To evaluate the functional outcomes of intramedullary interlocking nailing and minimally invasive percutaneous plate osteosynthesis. Study design: A longitudinal study Place and Duration: This study was conducted at Dow University of Health sciences Karachi Pakistan from January 2019 to January 2021. Methodology: A total of 100 patients were recruited for surgical procedures. All the patients were asked to visit the hospital at the 6th week, 3rd month, and 6th month of surgery for radiography assessment and for analyzing the knee and joint movements. When callus became visible on radiographs patients were allowed for partial weight-bearing. When callus was visible in 3 to 4 quadrants we considered it as fracture union on both anteroposterior and lateral views with no pain and mobility. Bone grafting was considered in case of fractures nonunion. Functional assessment was taken place after one year of surgery. Results: We observed that the IMIL group attained fracture union in an average duration of 25.90. But no statistical difference was observed between both groups. IMIL procedure has less duration of hospital stay when compared with MIPPO (6.40 (4–9) ± 1.19 vs 6.82 (5–10) ± 1.27. We observed 5° malunion in the MIPPO group whereas the IMIL group reported 10° malunion with a significant difference of 0.001. Conclusion: Our study concluded that the plating technique can better restore the distal tibia alignment but also has chances of postoperative complications which would be manageable. Keywords: Intramedullary interlocking nailing, minimally invasive percutaneous plate osteosynthesis, distal tibia