Comparative Analysis of Complication Rates in Tibial Shaft Fractures: Intramedullary Nail vs. Ilizarov External...

Area of Science:

• Orthopedic Surgery
• Trauma Management
• Biomechanical Engineering

Background:

• External fixation (EF) Ilizarov method offers efficacy and safety with unique biomechanical properties.
• Intramedullary nail fixation (IMN) presents an alternative with biomechanical stability and minimally invasive advantages.
• This study compares Ilizarov EF and IMN for tibia fractures during early IMN adoption in Serbia.

Purpose of the Study:

• To compare patient outcomes between Ilizarov EF and IMN for tibia diaphysis fractures.
• To evaluate factors influencing recovery time, pain reduction, and complications.
• To assess the early clinical experience with IMN in tibia fracture fixation.

Main Methods:

• Retrospective analysis of patients with closed and open (Gustilo and Anderson type I) tibial diaphysis fractures.
• Data collected included demographics, hospital stay, surgical details, complications, and Visual Analog Scale (VAS) pain scores.
• Comparison between 58 IMN patients and 74 Ilizarov EF patients treated between 2013 and 2017.

Main Results:

• IMN group showed significantly faster recovery (p < 0.001) and reduced pain intensity (p < 0.001) compared to EF.
• EF group had shorter surgery times (p < 0.001) and less antibiotic use (p < 0.001).
• Intramedullary fixation was a significant predictor of pain intensity; surgery length predicted complications.

Conclusions:

• Intramedullary nail fixation (IMN) provides superior outcomes in terms of faster recovery and pain reduction for tibia fractures over Ilizarov external fixation (EF).
• Surgical duration is a critical factor influencing the likelihood of postoperative complications.
• These findings support IMN as a favorable option for tibia fracture management.