Chin J Traumatol. 2021 Aug 11:S1008-1275(21)00128-0. doi: 10.1016/j.cjtee.2021.08.004. Online ahead of print.
ABSTRACT
PURPOSE: Treatment of distal tibia fractures poses significant challenge to orthopedic surgeon because of poor blood supply and paucity of soft tissue coverage. There is considerable controversy regarding the superior option of treatment for distal tibia fracture between the minimally invasive percutaneous plate osteosynthesis (MIPPO) technique and intramedullary interlocking (IMIL) nailing for extra-articular distal tibia fractures. The aim of our study is to compare the functional outcome between the two treatment methods.
METHODS: This was the prospective comparative study of 100 patients with distal third tibia fractures divided into two groups. First group of patients were treated with MIPPO technique while second group of patients were managed by IMIL nailing. Patients were followed up in outpatient department to assess the functional outcomes, malunion, delayed union, nonunion, superficial and deep infection between the two groups. Statistical analyses were performed using the SPSS software (version 16.0).
RESULTS: Average mal-union in MIPPO group was 5 (3-7) ± 1.41 vs. 10.22 (8-14) ± 2.04° in IMIL group (p = 0.001). Similarly postoperative knee pain in IMIL group was 10% vs. 2% in MIPPO group (p = 0.001). In terms of superficial infection and nonunion, the results were 8% vs. 4% and 2% vs. 6% for the MIPPO and IMIL group, respectively (p = 0.001).
CONCLUSION: Both procedures have shown the reliable method of fixation for distal extra-articular tibia fractures preserving the soft tissue, bony vascularity and fracture hematoma that provide a favourable biological environment for fracture healing. Considering the results of the study, we have slightly more preference for the MIPPO technique.
PMID:34503904 | DOI:10.1016/j.cjtee.2021.08.004
