Online ISSN: 2515-8260

Keywords : Distal Tibial Fracture

Treatment of Extra Articular Distal Third Tibia Fracture: Plating Versus Nailing

Mohamed Mansour El Zohairy, Mahmoud Saad Ebeid,Yousuf Mohamed Khira and Sherif Mohamed El Aidy

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 2774-2783

Background: The management of the fracture of lower third tibia remains a great
challenge to the surgeon. The present study was aimed to evaluate and compare the
intraoperative and postoperative outcomes between plate fixation, and
intramedullary nail for identifying proper indications of both methods of fixation.
Patients and Method: During 2015 - 2019, 96 cases with distal tibial fractures had
been treated using either M.I.P.O technique or Expert intramedullary nailing
technique, in a prospective study conducted in Zagazig University Hospitals. 48 cases
had been treated by M.I.P.O technique and 48 cases had been treated by Expert
intramedullary nailing technique.
Results: The results suggest that M.I.P.O technique was not always the best choice for all
types of fractures of lower third tibia. Expert I.M.N, with less soft tissue disruption, good
coronal, and sagittal alignment, was considered a standard operative treatment for
diaphyseal tibial fractures. However, cases with I.M.N should follow weight-bearing
restrictions until there is obvious callus formation in order to prevent malunion, broken
distal screws, or propagation of nail into ankle joint.
Conclusion: The study suggests that both Expert I.M nailing, and M.I.P.O.
techniques were appropriate treatments of distal tibial fractures. M.I.P.O. fixation,
and Expert I.M nailing were safe, and effective treatment options for fractures of
lower third tibia, because both of them could provide similar good function
outcomes. Expert I.M nailing must have the priority for distal tibial fractures with
soft tissue injury, or fractures that occurred more than 5 cm from the tibial plafond.
M.I.P.O should have the priority for distal tibial fracture with good skin condition,
soft tissue condition, or fractures that occurred less than 5 cm from tibial plafond.

Management of Extra Articular Distal Tibial FractureUsing Minimally Invasive Percutaneous Technique

Hasan Ali Qanaw,Mohsen Mohamed Abdo Mar'éi ,Reda Hussein ElKady , Ahmed Mohammed Abdelwahab

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 3057-3069

Background:Distal tibia fractures are challenging injuries. They are often caused by high
energy axial compressive, direct bending or low energy rotation forces. These fractures
constitute less than 10% of all tibial fractures. The aim of treating the fracture is to preserve
normal mechanical axis, ensure joint stability and restore a near full range of motion. This is a
difficult task to accomplish in each and every case due to compromised soft tissue condition,
variable bone quality and associated medical conditions. Distal tibia fractures are devastating
injuries that are usually due to highenergy
mechanisms such as falling from heights or motor
vehicle accidents. They may also occur from lowenergy
mechanisms, which are seen in
rotational injuries around the ankle. Results of conventional osteosynthesis with plates have
been suboptimal with reported complications of wound infection, skin breakdown and delayed
union or nonunion,
requiring secondary surgical intervention. Locking compression plating
has gained popularity and is being used frequently for fixation of distal tibia fractures. With the
use of minimal invasive techniques excellent results are obtained in complex fractures