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RMJ. 2021; 46(3): 568-571

Comparison between Plating and Intramedullary Nailing in the treatment of distal tibia fractures: A prospective comparative study

Niaz Hussain Keerio, Nuresh Kumar Valecha, Najeeb ur Rehman, Mohsin Aijaz Soomro, Ajmal Khan Silro, Muhammad Faraz Jokhio.

Objective: To compare the outcome of the two main treating modalities for Distal Tibia Fracture (Nailing, and Plating).
Methodology: This prospective comparative study was performed at Department of Orthopedics, Muhammad Medical College and Hospital, Mirpurkhas from March 2019 to March 2020. Out of 60 patients with distal tibia fractures, 30 were treated with Plating, and 30 with Intramedullary Nailing. Variables considered were total weight bearing, bone union, infection, alignment, need for secondary procedures, and the functional outcome after one year of follow up.
Results: Patient ages ranged from 20 to 78 years. The most common forms of injury were road traffic accidents (53.33%) and domestic accidents (46.66%). The time after the start of full weight bearing support was much shorter in the Nailing group (p=0.001). The average radiological union time in the nailing group was 18.911.20 weeks (range 19-23 weeks) and 24.081.17 weeks (range 22-30 weeks) in the plating group (p=0.001). Union was delayed in six patients in the plating group. Postoperative infection developed in 8(26.7%) in the Plating group, and none in Nailing group. Misalignments was detected in 2(6.6%) patients of Nailing group, and none in Plating group. After applying functional score of Olerud and Molander after 1 year, it was found that the average score in the Nailing group was 84.5% and 75.3% in Plating group.
Conclusion: Intramedullary interlocking nail was a safe and satisfactory method of treatment of extra- articular distal third of the tibia shaft fracture with good functional results and relatively low complications and high union rates. The platting of distal tibia has so many complications specially related to skin infection and wound dehiscence.

Key words: Tibia, tibial fractures, intramedullary nailing, metal plating.

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