A Comparative Study of Distal Tibia Metaphyseal Fractures in a Series of 50 Patients: Intramedullary Nailing (IMN) Vs Minimally Invasive Plate Osteosynthesis (MIPO)
Vol 6 | Issue 1 | Jan-Jun 2020 | page:17-21 – Tejas Tribhuwan, Chetan Pradhan, Atul Patil, Chetan Puram, Dheeraj Attarde, Parag Sancheti, Ashok Shyam
Author: Tejas Tribhuwan [1], Chetan Pradhan [1], Atul Patil [1], Chetan Puram [1], Dheeraj Attarde [1], Parag Sancheti [1], Ashok Shyam [1,2].
[1] Sancheti Institute of Orthopaedics and Rehabilitation, Pune, India.
[2] Indian Orthopaedic research group, Thane, India.
Address of Correspondence
Dr. Dheeraj Attarde,
Sancheti Institute of Orthopaedics and Rehabilitation, Pune, India.
E-mail: dheerajattarde@yahoo.in
Abstract
Introduction: Multiple treatment modalities have been described for distal tibia metaphyseal fractures but there is no consensus regarding optimal treatment. The purpose of this study was to compare the management of these fractures by intramedullary nailing (IMN) and minimally invasive plate osteosynthesis (MIPO) technique by assessing the functional and radiological outcomes and complications.
Methods: 50 patients having distal tibia fractures were studied and divided into two equal groups of IMN and MIPO with a follow-up period of one year. Functional assessment was done using SF-36, LEFS and VAS scores; radiological assessment was done by evaluating the union type and radiological deformity, and complications in both procedures were studied. Various fracture patterns were also considered.
Results: SF-36 showed no statistical significance with regard to treatment mode and fracture type. LEFS score reduced with increase in complexity of fracture and also indicated that both IMN and MIPO groups regained comparable functional capacity after a year. IMN cases (96%) showed better chances of primary union than MIPO cases (72%), after a year. Varus was found in 16% and valgus in 20% of plating cases. AO Type fractures 43 A1 and 43 A2 were preferably treated with nailing whereas 43 A3, with plating.
Conclusion: While union time is shorter for IMN cases, there is a greater occurrence of deformity in MIPO patients. We concluded that both the techniques can provide a similar return of functional capabilities but as the complexity of the fracture increases, nail becomes difficult to use than a plate.
Keywords: IMN; Distal tibia metaphyseal; MIPO; Distal third tibia fractures.
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| How to Cite this article: Tribhuwan T, Pradhan C, Patil A, Puram C, Attarde D, Sancheti P, Shyam A | A Comparative Study of Distal Tibia Metaphyseal Fractures in a Series of 50 Patients: Intramedullary Nailing (IMN) VS Minimally Invasive Plate Osteosynthesis (MIPO)| Trauma International | January-June 2020; 6(1):17-21. |
