Prospective Comparative Study of Functional Outcomes of Distal Extra-articular Tibia Fracture Fixed With...

Area of Science:

• Orthopedic surgery
• Traumatology
• Bone fracture repair

Background:

• Distal tibial fractures are common but challenging due to limited soft tissue and proximity to the ankle.
• Treatment selection for extra-articular distal tibial fractures remains debated, particularly between intramedullary nailing (IMN) and minimally invasive plate osteosynthesis (MIPO).
• Evaluating clinical, radiological, and functional outcomes is crucial for optimizing treatment strategies.

Purpose of the Study:

• To compare intramedullary nailing (IMN) versus locking compression plating (LCP) for extra-articular distal tibial fractures.
• To assess and compare clinical, radiological, and functional outcomes between IMN and LCP.
• To identify procedure-specific complications associated with each surgical technique.

Main Methods:

• A prospective comparative study involving 40 patients with extra-articular distal tibial fractures from March 2022 to March 2025.
• Patients were divided into two groups: 20 treated with IMN and 20 with locking compression plating (LCP).
• Clinical outcomes were assessed using the American Orthopaedic Foot & Ankle Society (AOFAS) score, with functional outcomes evaluated at one-year follow-up.

Main Results:

• All fractures achieved union at one year. The IMN group reported 35% excellent and 65% good outcomes, while the LCP group had 20% excellent, 60% good, 15% fair, and 5% poor outcomes.
• Complications occurred in 10% of the IMN group (superficial infections) and 20% of the LCP group (superficial/deep infections, persistent soreness).
• No malunion or nonunion was observed in either group, with comparable long-term functional results.

Conclusions:

• Both IMN and LCP provide favorable long-term results for extra-articular distal tibial fractures.
• IMN demonstrated advantages in shorter operative times, fewer complications, and better early functional outcomes compared to LCP.
• Further extensive research with longer follow-up periods is warranted to confirm these findings.