EXTRAARTICULAR DISTAL TIBIAL FRACTURES – LCP VERSUS INTRAMEDULLARY NAILING, part II.
Authors:
Vojtěch Pokorný
Authors place of work:
Fakultní nemocnice BrnoBohunice, Klinika úrazové chirurgie, Jihlavská
20
Published in the journal:
Úraz chir. 20., 2012, č.3
Category:
Clinical study
Summary
OBJECTIVE:
Author compares two basic types of internal fixation which compete in the area of the distal tibial metaphysis, i.e. locked intramedullary nailing and plate osteosynthesis, on the basis of monitoring the incidence of various complications, the duration of the fracture healing process and functional results.
MATERIAL AND METHODS:
Author presents a prospective study involving patients treated for extraarticular distal tibial fractures between 2005 and 2009. 38 patients (Group A) were treated with plate osteosynthesis, 53 patients (Group B) were treated using intramedullary nailing. Patients were observed for the incidence of infectious complications, angular malalignment, osteosynthesis failure and nonunion. Furthermore, fracture healing time and functional results were assessed.
RESULTS:
Infectious complications occurred in 5 patients in Group A (13.16 %), in 4 patients in Group B (7.55 %, α=0.38). Angular malalignment exceeding 5 degrees was observed once in Group A (2.63 %), and in five cases in Group B (9.43 %, α=0.2). Failure of osteosynthesis did not arise in Group A, but was observed in 3 patients in Group B (5.66%, α=0.14). Pseudoarthrosis occurred in 2 cases in Group A (5.26 %), and 3 cases in Group B (5.66 %, α=0.93). The average healing duration in Group A was 20.2 weeks, in Group B 20.1 weeks. Average AOFAS score were 85 for Group A and 89 for Group B.
CONCLUSION:
In Group A there was a greater incidence of infectious complications, while in Group B, there was a higher proportion of malunions and osteosynthesis failures. The differences in other parameters were negligible. Both methods may be considered standard procedures, with a place in treatment of this fractures. The method selected may be determined by competence and available technical equipment, as well as by expected complications.
KEY WORDS:
fracture, distal tibial metaphysis, plate, nail.
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