Comparison of Outcome of Locking Plate Fixation and Closed Intermedullary Interlocking Nail in the Management of Extra-articular Distal Tibial fractures
Background: Distal tibia fractures are the second highest incidence in tibia fractures. Management of distal tibia fracture is most
challenging due its superficial nature and propinquity to the ankle joint. Hence, two different techniques were used to treat such
Methods: Out of 26 patients, 13 were operated with interlocking nail (ILN) and 13 with locking plate fixation, patients were regularly
followed up to 1 year postoperatively, assessed clinically and radio-logically to rule out any complication and treated the same.
Results: Duration of surgery 40–60 min in 9 (69.2%) ILN, 5 (38.4%) plating 61–80 min in 4 (30.7%) ILN, and 5 (38.4%) in plating
>80 min observed in 3 (23%) only plating patients. Duration of total weight bearing 8–10 weeks in 9 (69.2%) IUN, 2 (15.3%) in
plating, 11–12 weeks in 4 (30.7%) ILN, 4 (30.7%) in plating, 13–14 weeks, and >14 weeks observed only in 2 (15.31%) plating
patients. Duration fracture union 16.9 (SD ± 1.48) in ILN, 20.7 (SD ± 1.84) in plating t-value 5.9 P < 0.001, post-surgical complications
– pain in anterior knee, 3 (23%) in ILN. superficial skin infection 1 (7.59%) in plating deep infection, 2 (15.3%) in plating valgus
>50 (angulations), 3 (23%) in IUL, and 2 (15.3%) in plating. Stiffing of knee 2 (15.3%) in ILN stiffness of ankle 1 (7.6%) in ILN,
3 (23%) in plating. Non-union 1 (7.6%) in ILN, implant irritation 3 (23%) in plating, and implant failure 1 (7.6%) in ILN.
Conclusion: Closed intermedullary nailing is preferable than planting technique because of early weight bearing, early union
and decreased implant related problems.
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