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.