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The radiological and
clinical outcomes of the locked plate and intramedullary nailing surgical
approach are comparable for the treatment of distal tibial fractures.
According to a study performed at Orthopedic Clinic, University Hospital of Parma Italy explains that the locked plate (LP) and intramedullary nailing (IMN), both surgical approaches exhibited similar radiological and clinical outcomes in the treatment of distal tibial fractures (DTF). The DTFs are one of the complex fractures with various complications. It is a therapeutic challenge to maintain DTF, with or without articular engagement.
The study was aimed
to compare radiological and clinical findings of LP and IMN surgical
interventions to improve DTF condition and to predict the unfavourable results.
The patients of age ≥18 years who treated at the first level trauma centre from
2008 to 2017 were involved and divided into two groups; first (IMN) and second
(LP). The registration of data related to the surgical procedure and
demographic variables were done. The nonunions and malunions were identified at
the follow-up using X-ray. Clinical findings were determined on the basis of scores
and any complication.
A total of 81
patients were involved in group 2 and 102 in group 1. Group 2 individuals were
associated with higher operating time and hospitalisation. The union time
noticed for LP and IMN were 24.8 and 20.2 weeks, respectively (p = 0.271). The
patients of group one were more prone to anterior knee pain and malunion
whereas group two patients found to be more susceptible to wound complications
and infections. After the six months, no difference was noticed regarding
clinical findings. LP group exhibited longer full-weight bearing time
(p = 0.019). No predictive power for unfavourable results during multivariate
analysis was seen. These outcomes reflected that both the interventions showed
similar findings.
International Orthopaedics
Treatment of distal tibial fractures: prospective comparative study evaluating two surgical procedures with investigation for predictive factors of unfavourable outcome.
Enrico Vaienti et al.
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