Treatment of distal third extra-articular fractures of tibia: Intramedullary interlocking nailing versus minimally invasive percutaneous plate osteosynthesis

Introduction: Technical difficulties exist in deciding the surgical modality for extraarticular fractures of tibia as both nailing and plating methods have advantages and the disadvantages of their own.Aims and Objective: To compare the functional outcome of distal third extraarticular fractures of tibia treated by intramedullary interlocking tibial nail and minimally invasive percutaneous plate osteosynthesis (MIPPO).Settings and Design: A prospective Randomized Control Study was conducted among patients who had distal one third extra-articular fractures of tibia. Materials and Methods: Thirty patients were treated with intramedullary nailing and 30 with MIPPO procedure. Patient were reviewed at 3 weeks, 6 weeks, 12 weeks and 6 months, at which weight bearing, Foot Function Index, Olerud Molander score, radiological union and complications were assessed. A prospective Randomized Control Study was conducted among patients who had distal one third extra-articular fractures of tibia. Statistical Analysis Used: Student t test and Mann Whitney U test were applied for comparison.Results: A total of 60 patients were included in the study. Partial weight bearing and full weight bearing were found to occur at an earlier stage in nailing as opposed to plating, with a statistical significance. Weight bearing without support was observed as early as 7 weeks in nailing when compared to plating which took 10 weeks. The functional outcome assessed by Foot Function Index and Olerud Molander Score showed a better outcome in nailing when compared to plating. The most common complication was delayed union in both groups with few other complications occurring among the patients in group 2Conclusion: Intramedullary Interlocking Tibial Nail is advantageous over MIPPO in terms of Early Mobilization, less soft tissue damage, and lower complication rate.Key Message: Intramedullary Interlocking Tibial Nail is advantageous over MIPPO in terms of Early Mobilization, less soft tissue damage, better and early radiological union and lower infection rate.