Abstract: Aim: To compare the outcome of locking plate fixation and closed intramedullary interlocking nail in the management of extra articular distal tibial fractures.
Methods: The prospective clinical study was conducted in the Department of Orthopaedics Hazaribagh Medical College, Hazaribagh, Jharkhand, India for the duration of 1 year. Total 40 Patients aged between 18 and 50 years presence of distal fragment of at least 3 cm in length without articular incongruity duration of injury <2 weeks no involvement of neuro-vascular status were include in the study. Patients with open fractures intra articular extension, pathological fractures were excluded from the study. Poor medical health was excluded from study.
Results: The classification of fractures 43 A.1– 10 (50%) ILN, and 10 (50%) plating 43 A.2–6 (30%) ILN, 4 (20%) plating, 43A.3–4 (20%) ILN, 4 (30%) plating. duration of surgery 40–60 min – 14 (70%) ILN, 8 (40%) plating, 61–80 min 6 (30%) ILN, 8(40%) plating, and >80 min 4 (20%) only in plating surgery. duration of total weight bearing after surgery 8–10 weeks 14 (70%) in ILN, 3 (15%) in plating, 11–12 weeks 6 (30%) ILN, 6 (30%) plating, 13–14 weeks 8 (40%) in plating, and >14 weeks 3 (15%) observed only in plating. duration of fracture union (radiological study) – 17.12 (SD ± 1.57) ILN 21.28 (SD ± 1.78) plating t-test –6.2 P < 0.001 (P-value was highly significant). study of post-surgical complications – pain in anterior knee – 5 (25%) in ILN, Superficial infection – 1 (5%) in plating Deep infection, 3 (15%) in plating valgus (angulations) >50 4 (20%) in ILN, 3 (15%) plating stiffness of knee 3 (15%) in ILN, stiffness of ankle 1 (5%) in ILN, 5 (25%) in plating, non-union 1 (5%) in IUN, implant irritation 5 (25%) in plating, and implant failure 5 in ILN.
Conclusion: Both closed intermedullary nailing and locking plate fixation equally safe and effective for the management of extra- articular distal tibia fractures.
