The distal tibia fractures are mainly due to road traffic accident, fall from height and sometimes twisting of ankle. Fractures around the ankle joint are difficult to manage because of precarious vascularity in nature. In addition it is in subcutaneous location which adds to further difficulty in the fracture management. Internal fixation devices such as locking intramedullary nails, locking compression plates are mainly used for the fracture fixation of distal tibia. It is critical to understand the fracture pattern occurring in the distal tibia and the form of fixation available.
Methods: A comparative study of management of fracture of distal one third tibia with low multidirectional locked nail and plating by MIPO was undertaken among 57 patients with extra-articular distal tibia fractures, in the department of orthopaedics, IMS & SUM Hospital, Bhubaneswar from June 2017 to June 2019. The Patients were followed up for clinical and radiological evaluation. The final results at the end of 1 year follow-up were evaluated using the Kaikkonen ankle score and Lysholm knee scoring system as excellent, good, fair, and poor.
Results: In IMLN group, mean time for union was 4.60+/-0.60months compared to 6.22+/-2.32 months in plating group which was significant (P=0.0018). Less complications in terms of delayed union, nonunion and incidence of infection and ankle stiffness, were seen in interlocking group as compared to plating group (P=0.001).
Conclusion: It is observed that low multidirectional locked nailing is better in terms of early total weight bearing, early union, and decreased risks of complications. Thus, it is a better choice for patient undergoing the treatment for extra- articular distal one third tibia fractures.