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Comparison of Plate VS. Nail Fixation for the Treatment of Distal Tibial Shaft Fractures in a Sample of Trauma Patients

Author: Ali A. Ali
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2015 Volume: 14 Issue: 2 Pages: 172-178
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية


ABSTRACT:BACKGROUND: Fractures of the distal third of the tibia are the major cause of morbidity in patients with lower extremity injuries. Most fractures are sustained in young adults during high velocity injuries.PATIENTS AND METHODS: Forty patients with closed fractures of distal third of the tibia were treated in Al-Yarmouk Teaching hospital between May 2012 and April 2014. 20 patients had been treated with open reduction and internal fixation by heavy-duty plate and screws and were matched to 20 patients treated with closed reduction and intramedullary nailing fixation, with regard to gender, age, and the AO classification of the fracture.RESULTS: There were no significant differences in regard to: time of surgical procedures, non-union, hardware failure or deep infections between plate fixation and intramedullary nailing. Open reduction and plate fixation was associated with higher risk of: delayed union, osteopenia, ankle joint stiffness and algodystrophy. Closed reduction with intramedullary nailing was associated with higher rates of rotational malalignment and knee joint pain/stiffness. The limb length difference was of no clinical significance in all patients.CONCLUSION: Intramedullary nailing is the preferred method for treating closed distal tibial fractures but open reduction and plate fixation may provide superior results in terms of optimal alignment.

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