Interlocking Nailing Versus Plating in Tibial Shaft Fractures in Adults: A Comparative Study
Introduction: Tibial diaphyseal fractures are the commonest long bone fractures in adults, most commonly managed by intramedullary interlocking nailing. However, several metaanalysis show that locking plate osteosynthesis is equally effective in managing tibial diaphyseal fractures and are assoc...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2017-04-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/9746/25577_CE[Ra1]_F(RK)_PF1_(SG_PY)_PFA(SS)_PF2(P_NESY).pdf |
| Summary: | Introduction: Tibial diaphyseal fractures are the commonest
long bone fractures in adults, most commonly managed by
intramedullary interlocking nailing. However, several metaanalysis show that locking plate osteosynthesis is equally
effective in managing tibial diaphyseal fractures and are
associated with less number of complications.
Aim: To compare the results of fixation of tibial fractures following
plating and nailing in terms of union, patient satisfaction and
complications.
Materials and Methods: A hospital based non randomized
clinical trial was performed from September 2013 to August 2016
where closed or open diaphyseal or metaphyseo- diaphyseal
fractures of the tibia (closed or open Gustilo Anderson type 1
through 3B) were included. Simple sequential allocation was
used for allotting the patients to two groups, one for interlocking
nailing and other for plating. The patients were followed up for
clinical, radiographic and functional results.
Results: Forty patients with 41 involved limbs completed follow
up for one year. The duration of surgery and average blood
loss during surgery was 75.45±3.03 minutes and 165.00±5.31
ml respectively in case of nailing and 85.05±2.54 minutes
and184.29±5.33 ml respectively in case of plating and their
difference was statistically significant. In our study union was
achieved in less than 20 weeks in 29 (70.8%) of the patients
and 25-30 weeks in nine (22%) cases. The average time of
union in our study was 19.55±0.69 weeks in case of interlocking
nailing and 20.38±1.39 weeks in case of plating and there was
no statistically significant difference between the two. However,
there is statistically significant difference in the functional
score in between the two groups in terms of Lower Extremity
Functional Score (LEFS). Delayed union in one case of nailing
and two cases of plating, valgus malunion in one case of nailing
and joint stiffness in two cases each of nailing and plating were
the major complications observed.
Conclusion: There was no difference between the two
modalities in terms of fracture union. Complications were lesser
but more serious in case of plating. Patient satisfaction was
more with plating. |
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| ISSN: | 2249-782X 0973-709X |