Plate or nail for distal tibia fractures: Is?there a clear answer?

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• 作者：Mohamed Ali ; Ahmed M A Othman ; Mohamed Yahya…
• 关键词：Distal tibia ; Minimally invasive plating ; Closed nailing
• 刊名：European Orthopaedics and Traumatology
• 出版年：2015
• 出版时间：June 2015
• 年：2015
• 卷：6
• 期：2
• 页码：91-97
• 全文大小：564 KB
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  12.Janssen KW, Biert J, VanKampen A (2007) Treatment of distal tibial fractures: plate versus nail: a retrospective outcome analysis of matched pairs of patients. Int Orthop 31(5):709-14View Article PubMed Central PubMed
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  16.Vallier HA, Le TT, Bedi A (2008) Radiographic and clinical comparisons of distal tibia shaft fractures (4 to 11?cm proximal to the plafond): plating versus intramedullary nailing. J Orthop Trauma 22:307-11View Article PubMed
  17.Vallier HA, Cureton BA, Paterson BM (2011) Randomized, prospective comparison of plate versus intramedullary nail fixation for distal tibia shaft fractures. J Orthop Trauma 25(12):736-41View Article PubMed
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• 作者单位：Mohamed Ali (1) (2)
  Ahmed M A Othman (1)
  Mohamed Yahya (1)
  Abdel-Wahab AL-Zahrani (2)
  
  1. Department of Orthopaedic and Trauma Surgery, El-Minia University Hospital, M. Badawy St., El-Minia, 61111, Egypt
  2. Department of Orthopedic Surgery, King Fahad Hospital, Al Baha, Kingdom of Saudi Arabia
  
• 刊物主题：Orthopedics; Traumatic Surgery; Conservative Orthopedics; Surgical Orthopedics; Sports Medicine;
• 出版者：Springer Berlin Heidelberg
• ISSN：1867-4577

文摘

Background Controversy still exists about the relative merits of the fixation devices for distal tibia fractures, and decision making remains difficult. Objectives This study aims to answer the question and find out when each implant is preferred. Patients and methods Of the patients treated at our hospitals for distal tibia fractures, 30 patients treated by minimally invasive plate osteosynthesis (MIPO) (group A) were matched to 30 patients treated by static reamed intramedullary nail (SR-IMN) (group B), with regard to age decade, gender, fracture type (open or closed), the AO/OTA classification of the fracture, and occupation category. Results No significant difference was found between the two groups regarding bone union and complications including angulation of >5°, shortening of >1?cm, implant failure, fixation loss, or deep infection. Group A had a shorter mean operative time and mean radiation exposure time. Group B had a?shorter mean time from trauma to surgery and faster full weight-bearing, radiographic union, and return to work. Only three patients lost their previous job, two in group A and one in group B. Conclusions Both implants are useful and effective. The clear answer is that no best implant and preoperative planning is the cornerstone to determine the patient, fracture, and surgeon factors that give priority for one implant over the other.