Keywords : extra-articular proximal tibia fracture
“A PROSPECTIVE STUDY OF COMPARISON BETWEEN FUNCTIONAL OUTCOME OF MULTIDIRECTIONAL INTERLOCKING INTRAMEDULLARY NAILING & LOCKING COMPRESSION PLATING IN EXTRA-ARTICULAR PROXIMAL TIBIA SHAFT FRACTURES”
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 3, Pages 1494-1519
Aims and objective: To study the functional outcome and duration of union of metaphyseo-diaphyseal fractures of tibia treated with Multidirectional Interlocking Intramedullary Nailing (ETN: Expert Tibia Nail) and Locking Compression Plating and achieve Restoration of axis, length, and rotation of the lower leg ;Sufficient primary stability of the osteosynthesis for early functional aftercare to maintain joint mobility
Methodology: We conducted a prospective study to know which definitive surgical treatment option (nailing or plating) is better for extra-articular proximal tibia fracture. Subjects who have sustained proximal tibia extra-articular fracture and who are admitted in Raja Rajeswari Medical College and Hospital , Bangalore were the sources. The Sample Size is 30. With 15in each group ( group A Plating and group B Nailing) .The functional outcome was assessed using Klemm Borner Knee Scoring system during clinical follow up at 6 weeks, 3months and at 6 months post surgery.
Results: Both Groups showed no significant difference in functional outcome assessed using Klemm Borner score , Klemm borner score in both groups initially at 6 weeks showed 26.7 % good results in plating group and 33.3 % good results in nailing group which progressed to give 60% excellent results in both groups and 26.7% good results in plating group and 33.3% in nailing group there were two complications encountered in our study patients post surgery which are osteomyelitis of tibia and non-union of proximal tibia fracture which were treated successfully accordingly.
Conclusion:: Considering lesser time for union, early weight bearing, lower chances of infection and lesser surgical duration, nailing seems to be more promising for extra articular proximal tibia fractures but Locking Compression Plating provides stable reduction in fractures like (AO41A2.2- simple metaphyseal oblique fracture in sagittal plane ) where as the reduction using nailing system in these fractures is cumbersome due to working length for a nail is shorter to control angulation n rotational deformity in these fractures ; But overall in our study there is no significant difference between two mode of treatment as far as early postoperative mobilization, intra operative blood loss, Hospital stay, klemm borner score and complication . It can be concluded that both the technique were equally effective and choice of methods for extra- articular proximal tibia fractures fixation depends on the surgeons own experience .