Treatment of distal tibial fractures: a prospective comparative study evaluating two surgical procedures with investigation for predictive factors of unfavourable outcome

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Treatment of distal tibial fractures: a prospective comparative study evaluating two surgical procedures with investigation for predictive factors of unfavourable outcome
Key Take-Away: 

‘Distal tibial fracture' is a heterogeneous group of fractures comprising the distal part of both tibia and fibula. This comparative analysis concluded that the clinical and radiological outcomes such as; the rate of infections, wound complications, malunion and anterior knee pain were found to be almost similar in both intramedullary nailing (IMN) and locked plate (LP) procedures.

Introduction:

This study aimed to compare the clinical and radiological outcome of IMN and LP in patients affected by fracture of distal tibia (DTF). The predictive factors of an unfavourable outcome were also identified.

 

Methods:

Data between 2008 and 2017 of patients with DTF treated at the first level trauma centre between 2008 and 2017 were collected. The patients were divided into group 1 (IMN) and group 2 (LP). Inclusion criteria were the at least 18 years age, at the time of diagnosis and unilateral DTF (closed or Gustilo 1). Demographic variables and data related to surgical procedure and hospitalisation were registered. At follow-up X-ray was reviewed to identify malunions and nonunions. Clinical outcome was evaluated using scores and recording any complication.

 

Results:

There were 102 patients included in group 1 and 81 in group 2. Higher operating time and hospitalisation were documented in group 2. The mean union time for IMN was 20.2 weeks and 24.8 weeks for LP group. The wound complications and rate of infections was higher in group 2 whereas malunion and anterior knee pain was higher in group 1. There was no difference in scores for clinical outcome after 6 months. LP group had significantly longer full-weight bearing time. At multivariate analysis, no variables depicted a predictive power for an unfavourable outcome.

 

Conclusions:

The clinical and radiological results of LP and IMN were almost similar. No predictive factors of unfavourable outcome were revealed.

Source

Int Orthop. 2018 Aug 22.

Link:

https://www.ncbi.nlm.nih.gov/pubmed/30135986

Original title of article:

Treatment of distal tibial fractures: prospective comparative study evaluating two surgical procedures with investigation for predictive factors of unfavourable outcome

Authors:

Vaienti E et al.

Exploratory, Fracture, Pain, Knee, Distal tibial, Prospective comparative study
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