Comparative study of intramedullary interlocking nailing and minimally invasive percutaneous plate osteosynthesis (MIPO) in extra articular distal tibial fracture

Abstract

Introduction: Tibia is one of the most commonly fractured long bone of the body. Distal tibia fractures are primarily located within a square based on the width of the distal tibia. Treatment of distal tibia fracture is challenging because of its unique anatomical characteristics of subcutaneous location with precarious blood supply and proximity to the ankle joint. Minimally invasive plate osteosynthesis (MIPO) and intramedullary interlocking nail (IMLN) are two well-accepted and effective methods Materials & Methods: Hospital based comparative study carried out to compare the effects of two different forms of treatment modalties of intramedullary nailing and minimally invasive plate osteosynthesis (MIPO). Total of 30 patients were enrolled in the study who were then randomly assigned groups for treatment modality using computer generated random numbers to receive type of treatment. Results: The operating duration in IMLN group ranged from 45 to 70 min (mean 56.4 ± 8.30 min) whereas in case of MIPO it ranged from 60 to 80 min. The average time of union in the IMLN group was 18.26 ± 2.49 weeks (range 15–24 weeks). In the MIPO group, union occurred in an average of 21.70 ± 2.67 weeks (range 16–24 weeks). The statistical difference between the two groups comes out to be very significant (P< 0.0001). Conclusion: We conclude that both minimally invasive percutaneous plate osteosynthesis (MIPPO) with a medial distal tibial locking plate and closed reduction with intramedullary nailing are viable options for management of extra-articular fractures of the distal tibia.