Distal tibia metaphyseal fractures: Which is better, intra-medullary nailing or minimally invasive plate osteosynthesis?

Introduction: Tibia fractures are the most common long bone fractures encountered by the orthopedic surgeons and distal tibia fractures have the second highest incidence of all tibia fractures after the middle third of tibia the distal tibial fractures are unique and are considered as most challengi...

Full description

Bibliographic Details
Main Authors: Abhijit Chandrakant Kawalkar, Chandrashekher Martand Badole
Format: Article
Language:English
Published: SAGE Publishing 2018-06-01
Series:Journal of Orthopaedics, Trauma and Rehabilitation
Online Access:http://www.sciencedirect.com/science/article/pii/S2210491716301105
_version_ 1818494841424707584
author Abhijit Chandrakant Kawalkar
Chandrashekher Martand Badole
author_facet Abhijit Chandrakant Kawalkar
Chandrashekher Martand Badole
author_sort Abhijit Chandrakant Kawalkar
collection DOAJ
description Introduction: Tibia fractures are the most common long bone fractures encountered by the orthopedic surgeons and distal tibia fractures have the second highest incidence of all tibia fractures after the middle third of tibia the distal tibial fractures are unique and are considered as most challenging fractures to treat due to its proximity to the ankle joint and its superficial nature. The objective of this study is to compare two osteosynthesis systems developed for surgical treatment of distal tibia fractures: the intramedullary nailing and the MIPPO technique. Methods: The study was conducted between Jan 2011 to Dec 2012. 63 patients with extra-articular distal tibia fracture treated with intramedullary nailing and MIPPO technique were reviewed retrospectively and clinical outcome was evaluated according to American Orthopaedic Foot and Ankle Score. Results: 31 patients were treated with intramedullary nail & 32 with MIPPO technique. Fibular fixation was done in cases where fibular fracture was at or below the level of tibial fractures. We found no difference in terms of time for fracture union, mal-union, non-union, duration of surgery and amount of blood loss. But there was significant difference in terms of infection and duration of hospital stay. Also weight bearing was possible much earlier in intramedullary group as compared to the MIPPO group. Conclusion: Thus we conclude that intramedullary nailing is better choice of implant in patients with extra- articular distal tibia fractures & helps in early weight bearing and ambulation of patient with fewer complications. 中 文 摘 要: 引言:脛骨骨折是骨科醫生遇到的最常見的長骨骨折;脛骨骨折中,遠端骨折比較中段三分之一骨折的發生率少,居第二位。由於其接近踝關節及其表面位置,脛骨遠端骨折是獨特的,被認為是治療難度最大的骨折。 本研究的目的是比較兩種脛骨遠端骨折內固定手術治療:髓內釘和微創鋼板內固定(MIPP) 技術。方法:回顧性分析2011年1月至2012年12月間的63例脛骨遠端骨折髓內釘和MIPPO技術治療。根據美國骨科足踝評分標準,對患者的臨床資料評價。結果:31例患者採用髓內釘治療,32例採用MIPPO技術。當腓骨骨折處於或低於脛骨骨折水平的情況下,進行腓骨固定。 我們發現骨折癒合時間、畸形癒合、不癒合率、手術時間和失血量沒有差異。 但感染率和住院時間差異有統計學意義。 與MIPPO組相比,髓內組可以更早負重。結論:因此,我們認為髓內釘是關節外脛骨遠端骨折患者更好的選擇,有助於患者早期負重和移動和較少並發症。 Keywords: distal tibia metaphyseal fracture, interlocking nail, minimally invasive plate osteosynthesis
first_indexed 2024-12-10T18:12:17Z
format Article
id doaj.art-9d72d24951934c9cbe88920107c4c21f
institution Directory Open Access Journal
issn 2210-4917
language English
last_indexed 2024-12-10T18:12:17Z
publishDate 2018-06-01
publisher SAGE Publishing
record_format Article
series Journal of Orthopaedics, Trauma and Rehabilitation
spelling doaj.art-9d72d24951934c9cbe88920107c4c21f2022-12-22T01:38:26ZengSAGE PublishingJournal of Orthopaedics, Trauma and Rehabilitation2210-49172018-06-01246671Distal tibia metaphyseal fractures: Which is better, intra-medullary nailing or minimally invasive plate osteosynthesis?Abhijit Chandrakant Kawalkar0Chandrashekher Martand Badole1Department of Orthopaedics, Global Hospital, Parel, Mumbai, Maharashtra 442001, India; Corresponding author. 101 Haridarshan Appartment, Jai Hind Colony, Dombivli (West), 421202, Maharshtra, India.Department of Orthopaedics, MGIMS, Sewagram, Wardha, Maharashtra, IndiaIntroduction: Tibia fractures are the most common long bone fractures encountered by the orthopedic surgeons and distal tibia fractures have the second highest incidence of all tibia fractures after the middle third of tibia the distal tibial fractures are unique and are considered as most challenging fractures to treat due to its proximity to the ankle joint and its superficial nature. The objective of this study is to compare two osteosynthesis systems developed for surgical treatment of distal tibia fractures: the intramedullary nailing and the MIPPO technique. Methods: The study was conducted between Jan 2011 to Dec 2012. 63 patients with extra-articular distal tibia fracture treated with intramedullary nailing and MIPPO technique were reviewed retrospectively and clinical outcome was evaluated according to American Orthopaedic Foot and Ankle Score. Results: 31 patients were treated with intramedullary nail & 32 with MIPPO technique. Fibular fixation was done in cases where fibular fracture was at or below the level of tibial fractures. We found no difference in terms of time for fracture union, mal-union, non-union, duration of surgery and amount of blood loss. But there was significant difference in terms of infection and duration of hospital stay. Also weight bearing was possible much earlier in intramedullary group as compared to the MIPPO group. Conclusion: Thus we conclude that intramedullary nailing is better choice of implant in patients with extra- articular distal tibia fractures & helps in early weight bearing and ambulation of patient with fewer complications. 中 文 摘 要: 引言:脛骨骨折是骨科醫生遇到的最常見的長骨骨折;脛骨骨折中,遠端骨折比較中段三分之一骨折的發生率少,居第二位。由於其接近踝關節及其表面位置,脛骨遠端骨折是獨特的,被認為是治療難度最大的骨折。 本研究的目的是比較兩種脛骨遠端骨折內固定手術治療:髓內釘和微創鋼板內固定(MIPP) 技術。方法:回顧性分析2011年1月至2012年12月間的63例脛骨遠端骨折髓內釘和MIPPO技術治療。根據美國骨科足踝評分標準,對患者的臨床資料評價。結果:31例患者採用髓內釘治療,32例採用MIPPO技術。當腓骨骨折處於或低於脛骨骨折水平的情況下,進行腓骨固定。 我們發現骨折癒合時間、畸形癒合、不癒合率、手術時間和失血量沒有差異。 但感染率和住院時間差異有統計學意義。 與MIPPO組相比,髓內組可以更早負重。結論:因此,我們認為髓內釘是關節外脛骨遠端骨折患者更好的選擇,有助於患者早期負重和移動和較少並發症。 Keywords: distal tibia metaphyseal fracture, interlocking nail, minimally invasive plate osteosynthesishttp://www.sciencedirect.com/science/article/pii/S2210491716301105
spellingShingle Abhijit Chandrakant Kawalkar
Chandrashekher Martand Badole
Distal tibia metaphyseal fractures: Which is better, intra-medullary nailing or minimally invasive plate osteosynthesis?
Journal of Orthopaedics, Trauma and Rehabilitation
title Distal tibia metaphyseal fractures: Which is better, intra-medullary nailing or minimally invasive plate osteosynthesis?
title_full Distal tibia metaphyseal fractures: Which is better, intra-medullary nailing or minimally invasive plate osteosynthesis?
title_fullStr Distal tibia metaphyseal fractures: Which is better, intra-medullary nailing or minimally invasive plate osteosynthesis?
title_full_unstemmed Distal tibia metaphyseal fractures: Which is better, intra-medullary nailing or minimally invasive plate osteosynthesis?
title_short Distal tibia metaphyseal fractures: Which is better, intra-medullary nailing or minimally invasive plate osteosynthesis?
title_sort distal tibia metaphyseal fractures which is better intra medullary nailing or minimally invasive plate osteosynthesis
url http://www.sciencedirect.com/science/article/pii/S2210491716301105
work_keys_str_mv AT abhijitchandrakantkawalkar distaltibiametaphysealfractureswhichisbetterintramedullarynailingorminimallyinvasiveplateosteosynthesis
AT chandrashekhermartandbadole distaltibiametaphysealfractureswhichisbetterintramedullarynailingorminimallyinvasiveplateosteosynthesis