Assessment of the treatment outcome of closed extra-articular distal tibia fracture: IM nailing vs plating

The tibial diaphyseal fractures are the most common type of long bone fractures encountered by most orthopedic surgeons. In accordance with descriptive indices of tibia fractures on the basis of their location in the bone, distal tibia fractures have the second incidence of all tibia fractures after the middle tibia fractures. The purpose of the study was to assess the complications and treatment outcome of closed extra-articular distal tibia fracture.

The results of the management for 76 patients with closed extra-articular distal tibia fracture by intramedullary nailing and plating were reviewed retrospectively. The variables included AO (Arbeitsgemeinschaft fur Osteosynthesefragen) classification of tibia fracture, the mean duration of union, malunion, and nonunion.

Twenty seven and forty nine patients were treated by intramedullary (IM) nailing and plating respectively. The most common type of fractures was A1 which was observed in twenty five patients. Initial union and nonunion occurred in sixty three and thirteen patients respectively. Eight patients had nonunion in plating group and five of twenty seven patients in IM nailing group. Eleven of twenty seven patients in IM nailing group suffered from malunion while only four patients in the other group had this complication.

The plating Technique in comparison with IM nailing has a satisfactory functional outcome. The technique has a lower incidence of malunion and nonunion, and it should be recommended as a good treatment option for the management of extra-articular closed fracture of distal tibia.