Comparative study of minimally invasive plate osteosynthesis and interlocking nailing in the management of closed distal tibia fracture: A randomised controlled trial

Authors

  • Banikanta Sharma Associate Professor, Department of Orthopedics, JNIMS, Imphal, Manipur, India
  • Chingshubam Imobi Singh Assistant Professor, Department of Orthopedics, JNIMS, Imphal, Manipur, India
  • Heisnam Kulabidhu Singh Associate Professor, Department of Community Medicine, JNIMS, Imphal, Manipur, India

Keywords:

Distal tibia fracture, Intramedullary interlocking nail (ILN), Minimally invasive plate osteosynthesis (MIPO)

Abstract

Introduction: Distal tibia fractures constitute 10-13% of all tibia fractures. There are two well accepted ways of surgical management of such fractures viz. minimally invasive plate osteosynthesis (MIPO) and intramedullary interlocking nailing (ILN). Earlier studies have shown that both have their inherent complications. Aims & objectives: The current study was done to compare the functional recovery among patients who had distal extra-articular fracture AO type 43A treated with ILN and MIPO technique. Material & methods: An RCT was done in the Orthopedics Department, JNIMS during Sept. 2018-Aug. 2020 among 62 adult patients who had closed distal tibia fractures and were medically fit for surgery. Demographic profiles and pre-operative findings were recorded. They were randomly allocated to two groups (ILN and MIPO). The intra-operative details were noted. Patients were then followed up every 4 weekly for 7-9 months until union occurred. Results were interpreted on the basis of AOFAS score for a minimum period of 5 months after surgery. Results: 60 adult patients (30 in each of the two intervention arms) could be followed up for the desired period. There was no significant difference in the time taken for surgery in both the two groups. The mean hospital stay in ILN group (6.4; SD-0.81 days) was found to be significantly shorter while compared to MIPO group (7.47; SD-2.67 days) (p=0.001). Otherwise, there were no significant differences regarding time taken for partial and full weight-bearing and time taken for union. Functional outcome was excellent in both arms (MIPO=90%; ILN-93.3%). The remaining cases had good scores. Anterior knee pain and mal-alignment were the main complications in ILN group (8; 23.8% each) whereas, ankle stiffness (8; 23.8%) and superficial infection (6; 20%) were the common complications in MIPO group. Conclusion: Both minimally invasive plate osteosynthesis with a medial distal tibial locking plate and closed reduction with intramedullary nailing are almost comparable in terms of the intra-operative and post-operative outcomes. Hence, both are viable options for management of extra-articular fractures of the distal tibia, with each having its own merits and demerits.

Downloads

Published

2021-12-31

How to Cite

Banikanta Sharma, Chingshubam Imobi Singh, & Heisnam Kulabidhu Singh. (2021). Comparative study of minimally invasive plate osteosynthesis and interlocking nailing in the management of closed distal tibia fracture: A randomised controlled trial. International Journal of Health and Clinical Research, 4(24), 14–16. Retrieved from https://www.ijhcr.com/index.php/ijhcr/article/view/3738