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International Orthopaedics
Published in: International Orthopaedics 1/2019

01-01-2019 | Original Paper

Treatment of distal tibial fractures: prospective comparative study evaluating two surgical procedures with investigation for predictive factors of unfavourable outcome

Authors: Enrico Vaienti, Paolo Schiavi, Francesco Ceccarelli, Francesco Pogliacomi

Published in: International Orthopaedics | Issue 1/2019

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Abstract

Purpose

The aim of this study is to compare clinical and radiological outcome of intramedullary nailing (IMN) and locked plate (LP) in patients affected by fracture of the distal tibia (DTF). We performed also an analysis to identify predictive factors of unfavourable outcome.

Methods

Data about patients with DTF treated at our first level trauma centre between 2008 and 2017 were collected. Patients were divided in group 1 (IMN) and group 2 (LP). The inclusion criteria were age at least 18 years at the time of diagnosis and unilateral DTF (closed or Gustilo 1). Demographic variables and data related to surgical procedure and hospitalization were registered. X-ray at follow-up was reviewed to identify malunions and nonunions. Clinical outcome was evaluated using scores and registering any complication.

Results

One hundred two patients were included in group 1 and 81 in group 2. In group 2 were documented higher operating time and hospitalization. The mean union time was 20.2 weeks for IMN and 24.8 weeks for LP group (p = 0.271). The rate of infections and wound complications was higher in group 2 while malunion and anterior knee pain were more frequent in group 1. No difference in scores for clinical outcome was documented after six months. The full-weight bearing time was significantly longer in the LP group (p = 0.019). At multivariate analysis, no variables showed a predictive power for unfavourable outcome.

Conclusions

Clinical and radiological results of LP and IMN appear similar. No predictive factors of unfavourable outcome were identified.
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Metadata
Title
Treatment of distal tibial fractures: prospective comparative study evaluating two surgical procedures with investigation for predictive factors of unfavourable outcome
Authors
Enrico Vaienti
Paolo Schiavi
Francesco Ceccarelli
Francesco Pogliacomi
Publication date
01-01-2019
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 1/2019
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-018-4121-6

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