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Intramedullary Nail Versus Minimally Invasive Plate Osteosynthesis for Displaced Extraarticular Proximal Tibia Fractures: A Prospective Comparative Cohort Study Publisher Pubmed



Teimouri M1 ; Mirghaderi P2 ; Parry JA3 ; Ziaei A4 ; Salimi M5 ; Tahririan MA1
Authors
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Authors Affiliations
  1. 1. Department of Orthopedic Surgery, Ayatollah Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Surgical Research Society (SRS) Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Orthopaedic Surgery, Denver Health Medical Center, Denver, United States
  4. 4. School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  5. 5. Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran

Source: European Journal of Orthopaedic Surgery and Traumatology Published:2023


Abstract

Purpose: The treatment of extraarticular proximal tibial fractures is challenging. As the optimal fixation technique is still debated, the purpose of this study was to compare minimally invasive plate osteosynthesis (MIPO) and intramedullary nail (IMN) fixation. Methods: A prospective matched comparative study was conducted on patients with displaced extraarticular proximal tibia fractures treated with MIPO (n = 29) versus IMN (n = 30) fixation. Outcomes collected were the Johner–Wruhs grading, range of motion (ROM), union rate, time to union, malunion, coronal and sagittal alignment, and post-operative complications. Results: Union rates were similar between the MIPO and IMN groups (93% vs. 97%, P = 1.0). The IMN group had an earlier time to union (15 vs. 18 weeks, P < 0.001) and superior functional outcomes at one year (effective Johner–Wruhs score: 80% vs. 55%, P = 0.04). There was a significantly higher incidence of anterior knee pain in the IMN group (23% vs. 0%, P = 0.02) and there was a trend for more infections in the MIPO group (21% vs. 13%, P = 0.73). Conclusion: IMN fixation of extraarticular proximal tibia fractures was associated with a shorter union time and better functional scores compared to MIPO. © 2023, The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.
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