COMPARATIVE STUDY OF PLATING VERSUS NAILING IN DISTAL TIBIA METAPHYSEAL FRACTURES

Abstract

Introduction: Distal tibial metaphyseal fracture is unique. The best option for surgical treatment of distal metaphyseal fractures of tibia is still unclear.

Objectives: This study was conducted to set the indications for both modalities of fixation in various fracture subtypes; and also to compare the functional outcomes of distal metaphyseal fractures of tibia managed by both methods at 2 years interval. Complication rates with different modalities of fixation were also studied.

Method: We have studied 40 pt in Sir JJ hospital group of hospitals from periods May 2009 to April 2011. The study was prospective and comparative for the methods used for management of the fracture.

Results: Age range of the patients was 18-65 yr. Most common mode of trauma in both the groups is road traffic accident. Associated fibula fracture was present in 18 (90%) participants in group 1 and 17 (85%) patients in group 2. Difference between 2 groups regarding duration of surgery is not significant. No significant intraoperative complications were noted in both groups. Time after which partial weight bearing and full weight bearing was started were significantly shorter in group1 (p=0.005). The average time before union was 23.45 weeks (range, 16-36 weeks) in group 1 and 26 weeks (range,19-41 weeks), (p=0.09). Malalignment was found in 25% of patients in group 1 and 10% of patients in group2. Angulation in group 1 was 3.4 degree (range, 0-12) and 1.0 degree (range,0-9) in group2 (p=0.04).

Conclusion: The overall results were comparable and most patients were satisfied with the results. These results indicate that both modalities of treatment deserve a place in treating distal metaphyseal fractures of tibia.