A Comparative Study on Functional and Radiological Outcome of Distal Tibial Fractures Managed with Intramedullary Interlocking Nail and Locking Compression Plate
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 3, Pages 2761-2772
AbstractBackground: Intramedullary interlocking nailing (IMIL) allows minimally invasive, symmetric, and dynamic fracture fixation by following the principles of biological fracture fixation. This technique is also used widely for distal tibial shaft fractures, with good results6. Presently, there is no clear consensus on optimal method of managing these fractures. Various surgical modalities used for these fractures include closed intramedullary nailing, plating by open or closed methods, and various types of external fixators. AIM: To compare the functional and radiological outcome of surgical modalities for distal tibia fracture, i.e. Minimally Invasive Percutaneous Plate Osteosynthesis (MIPPO) vs. Intra medullary Interlocking nail (IMIL) with respect to following parameters: Time to full weight bearing, Time to radiological union, Functional outcome and Complications.
Materials and Methods: Study Design: Prospective interventional study. Study area: The study was done in Department of Orthopaedics, KVG Medical College, Sullia, Dakshina Kannada, Karnataka, India. Study Period: October 2017 to September 2020. Study population: Adult patients with fractures of lower third tibia admitted in department of Orthopaedics KVG Medical College, Sullia, Dakshina Kannada, Karnataka, India. Sample size: 52. Sampling method: By universal sampling method. All patients with distal tibia fractures who satisfy the inclusion criteria have been included in the study. Patients will be allocated randomly into two groups using computer generated random numbers i.e., IMIL group and MIPPO group each with 26 patients. Statistical Analysis: The data were analysed using statistical software MS (Microsoft) Excel and SPSS (statistical package for social science) version 20. Data was presented as percentages or mean _ SD (standard deviation) as deemed appropriate for qualitative and quantitative variables, respectively. The chi-square test and Mann Whitney U test were applied to evaluate the statistical significance between the two groups. A P-value of < 0.05 was considered as statistically significant. All P-values reported are two-tailed.
Results: A total of 52 patients with extra articular distal tibial fractures were taken in our study and divided into two groups based on their mode of treatment. The most common mode of injury was found to be Road Traffic Accident (RTA), seen in 59.61% of the patients, followed by sports injury 25% (e.g., football), falls 09.6%, and direct blow 05.7%.
Conclusion: In this study average time taken for surgery and fracture union in patients treated by nailing is significantly lower when compared to the ones treated by plating. Time taken for full weight bearing and mobilization was significantly lower in nailing group than plating group
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