Journals / Cukurova Medical Journal / 2019 / Cilt: 44 - Sayı: 2

Comparison of Intramedullary nailing and minimally invasive percutaneous plate osteosynthesis in the treatment of extra-articular distal tibia fractures (AO-43A)

Eklem dışı distal tibia kırıklarının (AO-43A) tedavisinde intramedüller çivi ve minimal invaziv perkütan plak osteosentez uygulamalarının karşılaştırılması

Pages
464–470
Publication Date
2019-06-30
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

The follow-up OMAS score was 85±16.56 in the IMN group and 84.19±17.08 in the MIPPO group.Conclusion: Our study showed that IMN and MIPPO applications do not have a significant superiority to each other in the treatment of extra-articular distal tibia fractures, and both techniques can be successfully applied with low complications, high union rates and good functional results.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Purpose: The aim of this study was to compare the results of intramedullary nail (IMN) and minimally invasive percutaneous plate osteosynthesis (MIPPO) applications in the treatment of extra-articular distal tibia fractures.Materials and Methods: Thirty eight patients who underwent IMN and 31 patients who underwent MIPPO for extra-articular distal tibia fracture between January 2016 and April 2017 were included in the study.
📊
Key Findings & Data:The mean follow-up period was 20.12 ± 3.93 months.
💡
Conclusion & Impact:The follow-up OMAS score was 85±16.56 in the IMN group and 84.19±17.08 in the MIPPO group.Conclusion: Our study showed that IMN and MIPPO applications do not have a significant superiority to each other in the treatment of extra-articular distal tibia fractures, and both techniques can be successfully applied with low complications, high union rates and good functional results.
🔬Design:Research Article
📍Scope:2016 Verileri
⚙️Variables:Distal tibia kırığı · intramedüller çivi · minimal invaziv perkütan plak osteosentez

Abstract

Purpose: The aim of this study was to compare the results of intramedullary nail (IMN) and minimally invasive percutaneous plate osteosynthesis (MIPPO) applications in the treatment of extra-articular distal tibia fractures.Materials and Methods: Thirty eight patients who underwent IMN and 31 patients who underwent MIPPO for extra-articular distal tibia fracture between January 2016 and April 2017 were included in the study. The mean follow-up period was 20.12 ± 3.93 months. In patients, a comparison was made between groups by evaluating age, sex, side of injury, injury mechanism, presence of open fracture, presence of fibular fracture, union rates, infection rates, Olerud-Molander ankle score (OMAS) and malunion. Results: In the IMN group; the rate of concomitant fibula fracture was 18.4% and a plate was applied to 7.9% of all group. In the MIPPO group, the rate of concomitant fibula fracture was found in 58% of the patients, and a plate application was performed for 54.8% of all group. At the 6th month after surgery, the rate of union was found to be 92.1% in the IMN group, while it was 90.3% in the MIPPO group. The follow-up OMAS score was 85±16.56 in the IMN group and 84.19±17.08 in the MIPPO group.Conclusion: Our study showed that IMN and MIPPO applications do not have a significant superiority to each other in the treatment of extra-articular distal tibia fractures, and both techniques can be successfully applied with low complications, high union rates and good functional results.

Özet

Amaç: Bu çalışmanın amacı eklem uzanımı olmayan distal tibia kırıklarının tedavisinde intramedüller çivi (İMÇ) ve minimal invaziv perkütan plak osteosentez (MİPPO) uygulamaları sonuçlarının karşılaştırılmasıdır.Gereç ve Yöntem: Ocak 2016 ve Nisan 2017 tarihleri arasında eklem uzanımı olmayan distal tibia kırığı nedeniyle İMÇ uygulanan 38 hasta ve MİPPO uygulanan 31 hasta çalışmaya dahil edildi. Ortalama takip süresi 20,12±3,93 aydı. Hastalarda; yaş, cinsiyet, taraf, yaralanma mekanizması, açık kırık varlığı, fibula kırığı varlığı, kaynama oranları, enfeksiyon oranları, Olerud-Molander ayak bileği skoru (OMAS) ve dizilim bozuklukları değerlendirilerek gruplar arasında karşılaştırma yapıldı. Bulgular: İMÇ uygulanan grupta; eşlik eden fibula kırığı oranı %18.4 bulunurken, %7.9 fibula kırığına yönelik plak uygulanmıştı. MİPPO uygulanan grupta ise eşlik eden fibula kırığı oranı %58 hastada bulunurken, %54.8 fibula kırığına yönelik plak uygulanmıştı. Cerrahi sonrası 6. ayda kaynama oranı İMÇ uygulanan grupta % 92,1 olarak bulunurken, MİPPO uygulanan grupta % 90,3 olarak bulundu. Takip OMAS skoru İMÇ uygulanan grupta 85±16.56 olarak bulunurken, MİPPO uygulanan grupta 84.19±17.08 olarak bulundu.Sonuç: Çalışmamız; eklem uzanımı olmayan distal tibia kırıklarında, İMÇ ve MİPPO uygulamalarının birbirine belirgin bir üstünlüğünün olmadığını, her iki tekniğin düşük komplikasyon, yüksek kaynama oranları ve iyi fonksiyonel sonuçlar ile başarılı bir şekilde uygulanabileceğini desteklemektedir.

🔖

Cite This Article

ÖZER, M., KESİK, K., BAŞBUĞ, V., TÜRKMEN, F., KAÇIRA, B. K., KORUCU, İ. H., ÇOLAK, T. S., MEMİK, R. (2019). Comparison of Intramedullary nailing and minimally invasive percutaneous plate osteosynthesis in the treatment of extra-articular distal tibia fractures (AO-43A). Cukurova Medical Journal, Cilt: 44 - Sayı: 2, 464–470. https://ajindex.com/articles/56434

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (13)

  1. Newman SD, Mauffrey CP, Krikler S. Distal metadiaphyseal tibial fractures. Injury. 2011;42:975- 84
  2. Achten J, Parsons NR, McGuinness KR, Petrou S, Lamb SE, Costa ML. UK Fixation of Distal Tibia Fractures (UK FixDT): protocol for a randomised controlled trial of ‘locking' plate fixation versus intramedullary nail fixation in the treatment of adult patients with a displaced fracture of the distal tibia. BMJ Open. 2015;5:e009162
  3. Ma H, Zhao J, Yu B, Ye B. A gross anatomic study of distal tibia and fibula for single-incision approach. J Orthop Surg Res. 2014;9:28
  4. Wani IH, Gani N, Yaseen M, Bashir A, Bhat MS, Farooq M. Operative management of distal tibial extra-articular fractures - ıntramedullary nail versus minimally ınvasive percutaneous plate osteosynthesis. Ortopedia Traumatologia Rehabilitacja. 2017;19:537- 41
  5. Court-Brown CM, Rimmer S, Prakash U, McQueen MM. The epidemiology of open long bone fractures. Injury. 1998;29:529-34
  6. Bong MR, Kummer FJ, Koval KJ, Egol KA. Intramedullary nailing of lower extremity: biomechanics and biology. J Am Acad Orthop Surg. 2007;15: 97-106
  7. Mauffrey C, McGuinness K, Parsons N, Achten J, Costa ML. A randomised pilot trial of locking plate fixation versus intramedullary nailing for extraarticular fractures of the distal tibia. J Bone Joint Surg Br. 2012;94:704-8
  8. Iqbal HJ, Pidikiti P. Treatment of distal tibia metaphyseal fractures; plating versus intramedullary nailing: A systematic review of recent evidence. Foot and Ankle Surgery. 2013;19:143-7
  9. Mao Z, Wang G, Zhang L, Zhang L, Chen S, Du H, Zhao Y, Tang P. Intramedullary nailing versus plating for distal tibia fractures without articular involvement: a meta-analysis. Journal of Orthopaedic Surgery and Research. 2015;10:95
  10. Guo JJ, Tang N, Yang HL, Tang TS. A prospective, randomised trial comparing closed intramedullary nailing with percutaneous plating in the treatment of distal metaphyseal fractures of the tibia. J Bone Joint Surg Br. 2010;92:984-8
  11. Li Y, Jiang X, Guo Q, Zhu L, Ye T, Chen A. Treatment of distal tibial shaft fractures by three different surgical methods: a randomized, prospective study. Int Orthop. 2014;38:1261-7
  12. Castevens C, Le T, Archdeacon MT, Wyrick JD. Management of extra articular fractures of the tibia: intramedullary nailing versus plate fixation. J Am Acad Orthop Surg. 2012;20:675-83
  13. Vallier HA, Cureton BA, Patterson BM. Randomized, prospective comparison of plate versus intramedullary nail fixation