Comparison of Plating and Intramedullary Nailing for Treatment of the Closed Tibial Shaft Fractures

Tibial shaft fracture is one of the most common fractures in the lower limb which in the case of displacement or instability may need internal fixation. The aim of this study was to compare the results of plating and intramedullary nailing (IMN) for the treatment of closed tibial shaft fractures. In a prospective study 106 cases of closed tibial shaft fractures admitted to two of the teaching hospitals of Ahwaz during a 15 months period were treated alternatively with plating or intramedullary rod fixation. The union and complication rates were compared with a 12-months follow-up. From 50 cases treated by intramedullary rod and 56 who received plating 48 (96%) and 52 (92.9%) patients respectively achieved union. Non-union was observed in 4% of intramedullary rod and 7.8% of plate fixation cases. The infection rate in the plated tibias was significantly more than the intramedullary fixation cases (p=.034). The rodded cases had a shorter time to union than the plated ones (p=.006). Union of closed tibial fracture is similar whether fixed by intramedullary rod or plate. A higher infection rate and a slower time to union are however to be expected with plating.