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Abstract
Purpose
To compare the radiological and clinical results between intramedullary nailing and plate fixation in the treatment of distal tibial fractures.
Materials and Methods
19 cases of distal tibial metaphyseal fractures within 4 cm of the ankle joint line were enrolled. Ten patients were treated with interlocking intramedullary nail and the others with plate and screws.
Results
The mean union time was 14 weeks in nailing group and 16 weeks in plate group. The average angulation in AP view was 4.1 degrees in nailing group and 3.1 degrees in plate group. The average angulation in lateral view was 1.7 degrees in nailing group and 2.7 degrees in plate group. The rotational deformity was 2.8 degrees in nailing group and 1.7 degrees in plate group in average. There was no implant failure and soft tissue problem.
Conclusion
There was no difference in clinical and radiological results between intramedullary nailing and plate in the treatment of the distal tibial fractures and, considering the preservation of the soft tissue, the intramedullary nails are a reliable method for managing distal metaphyseal fractures of the tibia.
Figures and Tables
Fig. 1
(A) A 35-year-old man sustained a comminuted fracture of the left distal tibial metaphysis after slip down injury.
(B) Radiographs taken at 1 year after the injury show bony union and nail with five locking screws.
Fig. 2
(A) A 22-year-old man sustained a comminuted fracture of the right distal tibial metaphysis and fibula after slip down injury.
(B) Radiographs taken at 2 year after the injury show bony union and nail with four locking screws.
Fig. 3
(A) A 39-year-old man sustained a comminuted fracture of the right distal tibial after slip down injury.
(B) Radiographs taken at 11months after the injury show bony union and nail with four locking screws.
Fig. 4
(A) A 64-year-old woman sustained a comminuted fracture of the left distal tibial metaphysis after slip down injury.
(B) Radiographs taken at 1 year after the injury show bony union and plate and screws.
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