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International Orthopaedics
Published in: International Orthopaedics 4/2018

01-04-2018 | Original Paper

Extra-articular distal tibia fractures—controversies regarding treatment options. A single-centre prospective comparative study

Authors: Mihail-Lazar Mioc, Radu Prejbeanu, Bogdan Deleanu, Bogdan Anglitoiu, Horia Haragus, Marius Niculescu

Published in: International Orthopaedics | Issue 4/2018

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Abstract

Distal tibia fractures are reported to have a high complication rate pre-operatively as well as post-operatively, which can include open fractures, soft tissue damage, infection, malalignment, pseudarthrosis and ankle arthrosis. The operative treatment for the extra-articular distal tibia fractures is a controversial topic in the orthopaedic literature. Some of these fractures are proximal enough to be treated with an intramedullary nail while others are too distal for that. The aim of our study was to compare the results we have had with intramedullary nail (IMN) and minimally invasive plate osteosynthesis (MIPO) in distal metaphyseal (extra-articular) tibia fractures. The study was designed prospectively between January 2013 and March 2016 and took place on the Orthopaedics and Traumatology ward of a Clinical Emergency County Hospital in western Romania. The follow-up visits were scheduled one month, three months and six months post-operatively. For evaluating the ankle function, we used the Olerud–Molander ankle score (OMAS) and union was evaluated at six months on ankle X-rays. At the six-month follow-up visit the average scores were 75.55 (20-100) for the IMN lot and 74.23 (20-90) for the MIPO lot, without finding any statistical difference between the two groups (p >0.1). At the six-month follow-up, X-ray union was objected in 48 (90.5%) of our patients, the IMN lot having worse results (85.18%) than the MIPO lot (96.15%). The results we encountered showed little to no statistical difference when it comes to the functional score we used (OMAS score), leading us to believe that you can achieve comparable results with both implants.
Literature
1.
Digby JM, GMN H, Webb JK (1982) A study of function after tibial cast bracing. Injury 14:432–439CrossRef
2.
3.
Marcus MS, Yoon RS, Langford J et al (2013) Is there a role for intramedullary nails in the treatment of simple pilon fractures? Rationale and preliminary results. Injury 44:1107–1111CrossRefPubMed
4.
Li Y, Jiang X, Guo Q, Zhu L, Ye T, Chen A (2013) Treatment of distal tibial shaft fractures by three different surgical methods: a randomized, prospective study. Int Orthop 38:1261–1267CrossRef
5.
Kuhn S, Greenfield J, Arand C et al (2015) Treatment of distal intraarticular tibial fractures: a biomechanical evaluation of intramedullary nailing vs. angle-stable plate osteosynthesis. Injury 46:99–103CrossRef
6.
Kuo LT, Chi CC, Chuang CH (2015) Surgical interventions for treating distal tibial metaphyseal fractures in adults. Cochrane Database Syst Rev 3:Cd010261
7.
Piatkowski K, Piekarczyk P, Kwiatkowski K, Przybycien M, Chwedczuk B (2015) Comparison of different locking plate fixation methods in distal tibia fractures. Int Orthop 39(11):2245–2251CrossRefPubMed
8.
Kayali C, Agus H, Eren A, Ozluk S (2009) How should open tibia fractures be treated? A retrospective comparative study between intramedullary nailing and biologic plating. Ulus Travma Acil Cerrahi Derg 15(3):243–248PubMed
9.
Megas P, Zouboulis P, Papadopoulos AX, Karageorgos A, Lambiris E (2003) Distal tibial fractures and non-unions treated with shortened intramedullary nail. Int Orthop 27(6):348–351CrossRefPubMedPubMedCentral
10.
Li Y, Liu L, Tang X, Pei F, Wang G, Fang Y et al (2012) Comparison of low, multidirectional locked nailing and plating in the treatment of distal tibial metadiaphyseal fractures. Int Orthop 36:1457–1462CrossRefPubMedPubMedCentral
11.
12.
Wagner M, Frigg R (2006) AO manual of fracture management—internal fixators: concepts and cases using LCP/LISS. Thieme Publishing Group, Nederlands Tijdschrift voor Traumatologie
13.
14.
Deleanu B, Prejbeanu R, Crisan D, Predescu V, Popa I, Poenaru DV (2015) Gait characteristics before hardware removal in patients operated upon for tibial plateau fractures. Int Orthop 39(7):1411–1415CrossRefPubMed
15.
Gupta RK, Rohilla RK, Sangwan K, Singh V, Walia S (2010) Locking plate fixation in distal metaphyseal tibial fractures: series of 79 patients. Int Orthop 34(8):1285–1290CrossRefPubMed
16.
Paluvadi SV, Lal H, Mittal D, Vidyarthi (2014) Management of fractures of the distal third tibia by minimally invasive plate osteosynthesis—a prospective series of 50 patients. J Clin Orthop Trauma 5(3):129–136CrossRefPubMedPubMedCentral
17.
Ahmad MA, Sivaraman A, Zia A, Rai A, Patel AD (2012) Percutaneous locking plates for fractures of the distal tibia: our experience and a review of the literature. J Trauma Acute Care Surg 72(2:E):81–87CrossRef
18.
Zou J, Shi Z-M, Zhang W, Zhang C-Q (2012) Open reduction and internal fixation better than percutaneous plate osteosynthesis in distal tibial fractures. J Invest Surg Informa Healthcare USA 25(5):326–329
19.
Predescu V, Jinescu G, Olaru RI, Prescura C, Deleanu B (2016) Study of the tranexamic acid on blood loss in arthroplasty. RevChim 67(8):1513–1515
20.
Attal ELR, Hansen M, Rosenberger R, Smekal V, Rommens PM, Blauth M (2011) Intramedullary nailing of the distal tibia illustrated with the expert(TM) tibia nail. Oper Orthop Traumatol 23(5):397–410CrossRefPubMed
21.
Hoegel FW, Hoffmann S, Weninger P, Bühren V, Augat P (2012) Biomechanical comparison of locked plate osteosynthesis, reamed and unreamed nailing in conventional interlocking technique, and unreamed angle stable nailing in distal tibia fractures. J Trauma Acute Care Surg 73(4):933–938CrossRefPubMed
22.
Kuhn S, Appelmann P, Mehler D, Pairon P, Rommens PM (2014) Retrograde tibial nailing: a minimally invasive and biomechanically superior alternative to angle-stable plate osteosynthesis in distal tibia fractures. J Orthop Surg Res Bio Med Central Ltd 9(1):35
23.
24.
Shah AB, Jones C, Elattar O, Naranje SM (2017) Tibiotalocalcaneal arthrodesis with intramedullary fibular strut graft with adjuvant hardware fixation. J Foot Ankle Surg 56(3):692–696CrossRefPubMed
25.
Morris R, Hossain M, Evans A, Pallister I (2017) Induced membrane technique for treating tibial defects gives mixed results. Bone Joint J 99-B(5):680–685CrossRefPubMed
26.
Predescu V, Prescura C, Olaru R, Savin L, Botez P, Deleanu B (2017) Patient specific instrumentation versus conventional knee arthroplasty: comparative study. Int Orthop 41(7):1361–1367
27.
Haglin JM, Eltorai AE, Gil JA, Marcaccio SE, Botero-Hincapie J, Daniels AH (2016) Patient-specific orthopaedic implants. Orthop Surg 8(4):417–424CrossRefPubMed
Metadata
Title
Extra-articular distal tibia fractures—controversies regarding treatment options. A single-centre prospective comparative study
Authors
Mihail-Lazar Mioc
Radu Prejbeanu
Bogdan Deleanu
Bogdan Anglitoiu
Horia Haragus
Marius Niculescu
Publication date
01-04-2018
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 4/2018
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-018-3775-4

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