A comparative study of radiological and functional outcome of multidirectional locking nail with locking plate for management of distal Tibial Metaphyseal fractures

Background & Aims: Road traffic accidents and high-energy injuries are the leading cause of distal tibial metaphyseal fractures. The management of tibial fractures remains controversial despite advances in non-operative and operative care. Plates and intramedullary nails are well-accepted and effective methods, but each has been historically related to complications. The present study compared the results of displaced extra-articular distal metaphyseal tibia fractures. Materials & Methods: This descriptive cross-sectional study was conducted in the department of orthopedics at R. G. Kar medical college and hospital, Kolkata, West Bengal, India on 27 Locking Plate the 27 Multidirectional Plate patients attending orthopedics and emergency room with a tibia fracture from January 2019 to August 2020. All patients with extra-articular distal tibial fracture without distal neurovascular deficit, closed injury, or Gustillo Anderson type 1 were included. Post-operatively, X-rays were taken of the surgical site, and a series of X-rays were taken at 4, 16, 24, and 36 weeks’ intervals. SPSS v.27 and GraphPad Prism v.5 along with statistical tests were used. P values below 0.05 were considered significant. Results: In Locking Plate, 8(29.6%) patients were 21-30 years old, 10(37.0%) patients were 31-40 years old, and 9(33.3%) patients were 41-50 years old. In Multidirectional Nail, 6(22.2%) patients were 21-30 years old, 11(40.7%) patients were 31-40 years old, and 10(37.0%) patients were 41-50 years old. The Association of age with group was not statistically significant (p=0.8245). In Locking Plate, 11(40.7%) patients were female, and 16(59.3%) were male. In Multidirectional Nail, 10(37.0%) patients were female, and 17(63.0%) patients were male. The Association of sex with group was also not statistically significant (p=0.7801). Conclusion: We found that Fair outcome was more in Multidirectional Nails compared to Locking Plate for the AAOS Lower limb questionnaire at four weeks, which was not statistically significant. It was found that the excellent outcome was more in Multidirectional Nails compared to Locking Plate for the AAOS Lower limb questionnaire at five weeks, which was not statistically significant.