A Comparative Study of Intramedullary Interlocking Nail and Locking Plate Fixation in the Management of Extra Articular Distal Tibial Fractures

INTRODUCTION: Distal tibial fractures are very commonly encountered by orthopaedic surgeons. Our aim is to study and compare clinical and radiological outcome in extra articular fractures of distal tibia treated by interlocking intramedullary nails and locking plates with reference to rate of healing, functional outcome and complications. MATERIAL AND METHODS: In this study 30 patients with distal tibia extrarticular fractures, AO type 43 A were randomly selected and 15 of them were operated with interlocking nailing and remaining 15 with a locking plate. The patients were regularly followed up for a period of 1year and were evaluated clinically and radiologically with respect to tenderness at fracture site, abnormal mobility, infection, pain on movement of knee, ankle joints and anteroposterior and lateral radiographs of the leg for union of the fracture. RESULTS: In Interlocking group average time for union was 17.43 weeks compared to 21.40 weeks in plating group which was significant (p value <0.05). Also the average time required for partial and full weight bearing in the nailing group was 4.4 weeks and 9.53 weeks respectively which was significantly less (p value <0.0001) as compared to 7.07 weeks and 13.29 weeks in the plating group. Lesser complications in terms of implant irritation, ankle stiffness and infection (superficial and deep) were seen in interlocking group as compared to plating group. KEYMESSAGE: we recommend fibular fixation whenever intramedullary nailing or locking plate fixation is used in distal tibiofibular fractures. We concluded that due to early weight bearing, early union of the fracture and decreased implant related problems and closed intramedullary interlocking nailing is preferable in treatment of distal tibia fractures.