Operative Management of Distal Tibial Extra-articular Fractures – Intramedullary Nail Versus Minimally Invasive Percutaneous Plate Osteosynthesis

Abstract

MIPPO and intramedullary nailing are effective treatment options in the management of distal tibial extra particular fractures, with comparable functional outcomes.

Intramedullary Nailing Versus Minimally Invasive Plate Osteosynthesis for Distal Tibial Fractures: A Systematic Review and Meta‐Analysis

“…Malunion was defined as varus/valgus deformity >5° in the coronal plane, anterior/posterior angulation >10° in the sagittal plane, a rotational deformity >10°, and shortening >10 mm. When analyzed, the incidence of malunion, although part of RCTs in our meta‐analysis did not report significant difference between two groups, the pooled data pointed a higher incidence of malunion in IMN group than in MIPO group.…”

“…All of the RCTs reported the detailed data about fibular fixation except two studies. Ten RCTs were assessed by the Cochrane Handbook, and the detailed information of studies was displayed in Fig. .…”

“…were randomized by flipping a coin without reporting allocation concealment and blind. Allocation concealment of five studies were considered at unclear risk of bias. Guo et al .…”

“…suggested there was no significant difference about lateral deformity ( P = 1.000) and anteroposterior deformity ( P = 0.081) between IMN group and plate group; nevertheless they found shortening deformity (>10 mm) was associated with IMN group ( P = 0.028). Moreover, Wani et al . reported that patients treated with IMN had significantly higher rotational malalignment than plate, but they did not find any significant difference in varus or valgus deformity and anterior/posterior angulation.…”

Eklem dışı distal tibia kırıklarının (AO-43A) tedavisinde intramedüller çivi ve minimal invaziv perkütan plak osteosentez uygulamalarının karşılaştırılması

“…Özellikle İMÇ ve minimal invaziv perkütan plak ile osteosentez (MİPPO) uygulamaları, kırık hattı direkt olarak açılmadığından vasküler desteğin daha fazla korunması ile kaynamama ve yumuşak doku problemlerini azaltmaktadır. Eklem uzanımı olmayan distal tibia kırıklarının cerrahi tedavisi için MİPPO uygulamalarından önce kullanılan konvansiyonel plak uygulamalarına göre İMÇ ile biyoloji daha iyi korunup komplikasyon oranları daha az görülmekteyken, günümüzde MİPPO ile İMÇ uygulamalarının birbirlerine belirgin üstünlükleri gösterilememiştir 4,[7][8][9][10][11] . Özellikle distal parçası küçük olan kırıklarda, MİPPO ile distal parçaya birden çok kilitli vida gönderilebileceğinden yeterli stabilizasyon sağlanabilir.…”