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Treatment of distal tibial fractures: prospective comparative study evaluating two surgical procedures with investigation for predictive factors of unfavourable outcome.
- Source :
-
International orthopaedics [Int Orthop] 2019 Jan; Vol. 43 (1), pp. 201-207. Date of Electronic Publication: 2018 Aug 22. - Publication Year :
- 2019
-
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.<br />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.<br />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 (pā=ā0.271). 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 (pā=ā0.019). At multivariate analysis, no variables showed a predictive power for unfavourable outcome.<br />Conclusions: Clinical and radiological results of LP and IMN appear similar. No predictive factors of unfavourable outcome were identified.
- Subjects :
- Adult
Aged
Bone Plates
Female
Fracture Fixation, Intramedullary methods
Fracture Healing
Humans
Male
Middle Aged
Minimally Invasive Surgical Procedures
Prognosis
Prospective Studies
Tibia diagnostic imaging
Tibia injuries
Tibia physiopathology
Tibial Fractures diagnostic imaging
Tibial Fractures physiopathology
Treatment Outcome
Weight-Bearing
Young Adult
Fracture Fixation, Internal methods
Tibia surgery
Tibial Fractures surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1432-5195
- Volume :
- 43
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- International orthopaedics
- Publication Type :
- Academic Journal
- Accession number :
- 30135986
- Full Text :
- https://doi.org/10.1007/s00264-018-4121-6