COMPARATIVE ANALYTICAL STUDY OUTCOME OF MULTIDIRECTIONAL LOCKED NAILING AND PLATING FOR DISTAL TIBIAL FRACTURES

Dr. A. Anand Kumar M.S. Ortho* Dr. N. Prasanna Venkateshan M.S. Ortho

ABSTRACT

Introduction: Distal tibial fractures are very commonly encountered by orthopaedic surgeons. Our aim is to study and compare clinical and radiological outcome in extra articular fractures of distal tibia treated by multidirectional interlocking intramedullary nails and anterolateral locking compression plates with reference to rate of healing, functional outcome and complications. Material And Methods: In this study 24 patients with distal tibia extrarticular fractures, AO type 43 A1,43 A2, 43A3 were randomly selected and 12 of them were operated with multidirectional interlocking nailing and remaining 12 with anterolateral locking compression plate. The patients were regularly followed up for a period of one year and were evaluated clinically and radiologically with respect to tenderness at fracture site, abnormal mobility, infection, pain on movement of knee, ankle joints and anteroposterior and lateral radiographs of the leg for union of the fracture. Results: In multidirectional Interlocking intramedullary group average time for union was 4.5months compared to 6.4 months in plating group which was significant (p value <0.00). Also the average time required for partial and full weight bearing in the nailing group was 4.2 weeks and 9.6 weeks respectively which was significantly less (p value <0.00) as compared to 7.12 weeks and 13.42 weeks in the plating group. Lesser complications in terms of implant irritation, ankle stiffness and infection (superficial and deep) were seen in interlocking group as compared to plating group. Conclusion: We concluded that due to early weight bearing, early union of the fracture and decreased implant related problems and closed intramedullary interlocking nailing is preferable in treatment of distal tibia fractures. We recommend fibular fixation whenever intramedullary nailing or locking plate fixation is used in distal tibiofibular fractures.

Keywords: Distal Tibia Fractures, Fibular Fixation, Locking Plate, Interlocking Nailing.