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SA Orthopaedic Journal

On-line version ISSN 2309-8309
Print version ISSN 1681-150X

Abstract

BARAL, R  and  RAJ, Kandel P. A preliminary comparison between intramedullary interlocking nail and minimally invasive plate osteosynthesis in extra-articular distal tibia fractures: a retrospective study. SA orthop. j. [online]. 2017, vol.16, n.4, pp.54-58. ISSN 2309-8309.  http://dx.doi.org/10.17159/2309-8309/2017/v16n4a9.

AIMS: To compare functional outcome between intramedullary interlocking nail (IMIL) versus minimally invasive plate osteosynthesis (MIPO) in the distal one-third extra-articular tibia fracture. PATIENTS AND METHODS: We retrospectively analysed 42 cases (21 each) of the IMIL nail versus locking plate by MIPO technique. All patientswere followed for at least one year since the last case operated. This study included closed distal tibia fractures above 4 cm to 10 cm and fibula fractures. Fibula fractures within 7 cm of the tibial plafond were fixed with Kirschner wire (K-wire). We excluded all comminuted open fractures, intra-articular extension, and isolated fracture of the tibia from the study. Foot function index, union time, rotational and angular malalignment, rate of infection, secondary interventions and complications were compared between the groups. RESULTS: All patients were retrospectively analysed. Coronal (P=0.259) and sagittal plane malalignment (P=0.147), distraction (P=0.147), rotation (P=0.147), delayed union (P=0.549), non-union (P=0.311), infection (P=0. 549), malunion (P=0.147), amputation (P=0.311), secondary intervention (P=0.116), and foot function index (P=0.217) were all similar between the groups. Time to union was earlier in the MIPO group (P=0.033). We, however, used the MIPO technique in the younger age groups (P=0.042). Coronal plane deformity in both groups was associated with a higher rate of complications, which was also statistically significant (P=0.012). CONCLUSION: Our study suggests that similar outcomes appear through IMIL nail and MIPO of distal extra-articular tibia fractures. Time to union was faster in the MIPO cases, but other factors, such as age, might have played a role. Level of evidence: Level 3

Keywords : intramedullary interlocking nail; minimally invasive plate osteosynthesis; alignment; distal tibia.

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