Comparative study between interlocking nail and locked plate in distal tibia fractures fixation / Abdulrhman Adel Moawad Hassan ; Supervised Amr Wael Farag , Ahmed Samy Elmaghraby

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Orthopedic Surgery

Background: Distal tibia shaft fractures accounts for approximately 37.8% of all tibial injuries. Fractures of the distal tibia affecting all ages. Treatment of distal tibial fractures in skeletally mature patients without articular extension is challenging because of its unique anatomical characteristics of subcutaneous location with week blood supply and proximity to the ankle joint. Aim: To compare Interlocking nail (ILN) versus Distal tibial locked plate with minimally invasive technique (MIPPO) for fixation of this fracture. Materials and methods: A prospective randomized study was conducted involving 30 patients divided into two groups. Patients were assessed clinically using American Orthopaedic Foot and Ankle Society (AOFAS) and radiologically at 6 months. Results: The mean age for the MIPPO group was 35 ± 15.83 years, while the mean age for the ILN group was 34.33 ± 15.07 years. The mean follow up period was 7.13 months with a minimum of 6 months for all patients included. No statistical significance was found when the two groups were compared except in time for union.Mean time for union in ILN 14 ± 2.85 weeks, while in MIPPO group 17,07 ± 4.01 weeks. This showing statically significant for ILN. Conclusion: Both techniques can provide effective treatment and fixation for closed or G1 distal tibial extraarticular fractures. ILN showing lower infection rate and faster time to healing but with more mal-alignment reduction. While in MIPPO technique less mal-alignment reduction can achieved but with more infection problems and slower rate of union

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