PURPOSE: The purpose of this randomized clinical trial is to compare intramedullary nailing (IMN) versus minimally invasive plate osteosynthesis (MIPO) for the treatment of extra-articular distal tibial shaft fractures. MATERIALS AND METHODS:Twenty-five consecutive patients with distal extra-articular tibial fractures which were located between 4 and 12 cm from the tibial plafond (AO 42A1 and 43A1) were randomly assigned into IMN (n: 10) or MIPO (n: 15) treatment groups. All patients were followed for at least 1 year. Foot function index, time to weight bearing, union time, duration of operation, length of incision, intra-operative blood loss, intra-operative fluoroscopy time, rotational and angular malalignment, rate of infection, secondary interventions and complications were compared between groups. RESULTS: All patients completed the trial and were followed with a mean of 23.1 ± 9.4 months (range 12-52). Foot function index, weight bearing time, union time, rate of malunion, rate of infection and rate of secondary interventions were all similar between groups (p = 0.807, p = 0.177, p = 0.402, p = 0.358, p = 0.404, p = 0.404, respectively). Intra-operative blood loss, length of surgical incision, radiation time and rotational malalignment were higher in the IMN group (p = 0.012, p = 0.019, p = 0.004 and p = 0.027, respectively). CONCLUSIONS: Results of our study showed that both treatment methods have similar therapeutic efficacy regarding functional outcomes and can be used safely for extra-articular distal tibial shaft fractures, and none of the techniques had a major advantage over the other.
RCT Entities:
PURPOSE: The purpose of this randomized clinical trial is to compare intramedullary nailing (IMN) versus minimally invasive plate osteosynthesis (MIPO) for the treatment of extra-articular distal tibial shaft fractures. MATERIALS AND METHODS: Twenty-five consecutive patients with distal extra-articular tibial fractures which were located between 4 and 12 cm from the tibial plafond (AO 42A1 and 43A1) were randomly assigned into IMN (n: 10) or MIPO (n: 15) treatment groups. All patients were followed for at least 1 year. Foot function index, time to weight bearing, union time, duration of operation, length of incision, intra-operative blood loss, intra-operative fluoroscopy time, rotational and angular malalignment, rate of infection, secondary interventions and complications were compared between groups. RESULTS: All patients completed the trial and were followed with a mean of 23.1 ± 9.4 months (range 12-52). Foot function index, weight bearing time, union time, rate of malunion, rate of infection and rate of secondary interventions were all similar between groups (p = 0.807, p = 0.177, p = 0.402, p = 0.358, p = 0.404, p = 0.404, respectively). Intra-operative blood loss, length of surgical incision, radiation time and rotational malalignment were higher in the IMN group (p = 0.012, p = 0.019, p = 0.004 and p = 0.027, respectively). CONCLUSIONS: Results of our study showed that both treatment methods have similar therapeutic efficacy regarding functional outcomes and can be used safely for extra-articular distal tibial shaft fractures, and none of the techniques had a major advantage over the other.
Authors: Matthew L Costa; Juul Achten; James Griffin; Stavros Petrou; Ian Pallister; Sarah E Lamb; Nick R Parsons Journal: JAMA Date: 2017-11-14 Impact factor: 56.272
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Authors: Nils Jan Bleeker; Nicole M van Veelen; Bryan J M van de Wall; Inger N Sierevelt; Björn-Christian Link; Reto Babst; Matthias Knobe; Frank J P Beeres Journal: Eur J Trauma Emerg Surg Date: 2022-01-04 Impact factor: 2.374
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