A prospective comparative study of distal tibia and fibula fractures treated with tibial interlocking nailing with and without fibular plating
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20251802Keywords:
Tibia, Fibula, Interlocking nail, Karlstrom Olerud score, Malalignment, Distal metaphysealAbstract
Background: Distal both bone leg fractures present significant challenges in orthopedic surgery. The purpose of this study was to evaluate the functional and radiological outcomes of tibial interlocking nailing alone versus interlocking nail with supplementary fibular plating.
Methods: A hospital-based, prospective interventional study was conducted on 72 patients, divided into two groups. Karlstrom-Olerud scoring and radiographic assessment were used to evaluate outcomes. SPSS software will be used for all statistical calculations.
Results: Patients in the interlocking nail with fibular plating group demonstrated improved alignment values in varus/valgus angulation (p=0.00008) and anteroposterior angulation (p=0.00029), also Karlstrom Olerud score was significantly better in fibular plating group at 3 months (p=0.002). There was slightly earlier union time in fibular plating group than patients without fibular plating (14.86 and 15.55 respectively) and also there was higher rate of patients requiring secondary procedures in group without fibular plating (6) compared to group with fibular plating (2).
Conclusion: Patients with fibular plating group demonstrated significantly improved alignment and functional scores, suggesting that supplementary fibular plating enhances stability and reduces malalignment.
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References
Brown CM, McBirnie J, Wilson G. Adult ankle fractures: an increasing problem. Acta Orthop Scand. 1998;69:43–47. DOI: https://doi.org/10.3109/17453679809002355
Koval KJ, Lurie J, Zhou W. Ankle fractures in the elderly: what you get depends on where you live and who you see. J Orthop Trauma. 2005;19:635–9. DOI: https://doi.org/10.1097/01.bot.0000177105.53708.a9
Kannus P, Palvanen M, Niemi S, Parkkari J, Jrvinen M. Increasing number and incidence of low-trauma ankle fractures in elderly people: Finnish statistics during 1970–2000 and projections for the future. Bone. 2002;31(3):430-3. DOI: https://doi.org/10.1016/S8756-3282(02)00832-3
Canale ST, Beaty JH. Campbell's operative orthopaedics e-book: expert consult premium edition-enhanced online features. Elsevier Health Sciences; 2012.
Guo J, Tang N, Yang H, Tang T. A prospective, randomised trial comparing closed interlocking nailing with percutaneous plating in the treatment of distal metaphyseal fractures of the tibia. J Bone Joint Surg Br. 2010;92:984-8. DOI: https://doi.org/10.1302/0301-620X.92B7.22959
Karstrom G, Olerud S. Fractures of tibial shaft, a clinical evaluation of treatment alternatives. Clin Orthop. 1974;105:82-115. DOI: https://doi.org/10.1097/00003086-197411000-00006
Campbell’s Operative orthopaedics. 10th ed. Volume 3. Mosby Publication; 2003: 2671-3.
Egol KA, Weisz R, Hiebert R, Tejwani NC, Koval KJ, Sanders RW. Does fibular plating improve alignment after intramedullary nailing of distal metaphyseal tibia fractures. J Orthop Trauma. 2006;20(2):94-103. DOI: https://doi.org/10.1097/01.bot.0000199118.61229.70
Nork SE, Schwartz AK, Agel J, Holt SK, Schrick JL, Winquist RA. Intramedullary nailing of distal metaphyseal tibial fractures. JBJS. 2005;87(6):1213-21. DOI: https://doi.org/10.2106/00004623-200506000-00005
Puno RM, Vaughan JJ, Stetten ML, Johnson JR. Long-term effects of tibial angular malunion on the knee and ankle joints. J Orthop Trauma. 1991;5(3):247-54. DOI: https://doi.org/10.1097/00005131-199109000-00001
James K. Commentary and prospective on Effect of fibular plate fixation on rotational stability simulated distal tibial fractures treated with intramedullary nailing by Anantkumar. eJBJS. 2003:32.
Kumar A, Charlebois SJ, Cain EL, Smith RA, Daniels AU, Crates JM. Effect of fibular plate fixation on rotational stability of simulated distal tibial fractures treated with intramedullary nailing. JBJS. 2003;85(4):604-8. DOI: https://doi.org/10.2106/00004623-200304000-00003
Whittle AP, Wester W, Russell TA. Fatigue failure in small diameter tibial nails. Clin Orthop Relat Res. 1995;(315):119-28. DOI: https://doi.org/10.1097/00003086-199506000-00013