Abstract: Background: We Assessed patients with Functional recovery between two treatment modality intramedullary interlocking nail and locking plate fixation in the surgical management of extra-articular distal tibia fracture. In high energy distal tibial fractures younger age groups are involved due to road traffic accident and fall from height. Axial loading, compression and torsional forces are involved in the mechanism of injury. Distal tibial fractures are very commonly encountered by orthopaedic surgeons.
Aims and Objectives: To study and compare clinical and radiological outcome in extra articular fractures of distal tibia treated by multidirectional interlocking intramedullary nails and anterolateral locking compression plates with reference to rate of healing, functional outcome and complications.
Material and Methods: In this study 26 patients with distal tibia extra-articular fractures, AO type 43 A1, 43A 2,43A3 were randomly selected and 13 of them were operated with multidirectional interlocking nailing and remaining 13 with anterolateral locking compression plate. The patients were regularly followed up for a period of one year and were evaluated clinically and radiologically with respect to tenderness at fracture site, abnormal mobility, infection, pain on movement of knee, ankle joints and anteroposterior and lateral radiographs of the leg for union of the fracture.
Results: About 42 to 52% complication rate was attributed in internal fixation device and extensive surgical procedure due to soft tissue injury. Therefore ankle spanning external fixation became popular to maintain the articular surface of tibia with minimal internal fixation. In multidirectional Interlocking intramedullary group average time for union was 4.5 months compared to 6.4 months in plating group which was significant (p value<0.00). Also the average time required for partial and full weight bearing in the nailing group was 4.2 weeks and 9.6 weeks respectively which was significantly less (p value <0.00) as compared to 7.12 weeks and 13.42 weeks in the plating group. Lesser complications in terms of implant irritation, ankle stiffness and infection (superficial and deep) were seen in interlocking group as compared to plating group.
Conclusion: Here we will conclude lateral radiographs of the distal third of the tibia are of great importance for the diagnosis. The management of these fractures is usually operative. Plate fixation for distal tibia fracture is associated with non-union, delayed union, sloughing of overlying skin, and infection. Interlocking intramedullary nailing is now more preferred weight bearing, early union of the fracture and decreased implant related problems and closed in treatment of distal tibia fractures.
