A analysis of comparative study on intramedullary locking nail and plating for periarticular fractures of distal tibia
Authors: Mathun Ram*,Bharath ,Sundharaja
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Aim and Objective: Our aim is to find out the best line of treatment both radiologically and clinically for the extra articular fractures of the distal tibia treated with imil nailing and plating.
Materials and Methods: From 2016 may till 2018 January all patients with extra articular fractures were taken for the study. All are closed fractures.17 patients under went imil nailing and 15 underwent distal tibia plating patients with diabetes, smokers, alcoholics were included in relation to wound healing. Results were analysed as per the scoring the two sets of patients were analysed for infection, skin necrosis, non-union, malunion, ankle rom, knee pain, shortening etc.
Results: in plating no infection, skin necrosis in one patient, non-union noticed in 3 patients and finally in 9months all united except one malunion is more in plating, ankle rom, stiffness is noticed knee pain noticed in few cases of imil nailing cases, shortening noticed in one case in plating results are graded as excellent, good, fair, and poor. In nailing-no infection, no skin necrosis, nononunion, no angulation, ankle rom full, knee pain in 1case,and no shortening results were graded as excellent, good, fair and poor both groups were compared.
Discussion: Imil cases bone united in 8w, early weight bearing, no infection, skin necrosis, no angulation, no shortening noticed.
In plating shortening, delayed union, angulation, ankle stiffness which is not seen in imil smoking diabetes, and alcoholics landed up in skin necrosis and plate exposures.
Conclusion: In our study we found imil nailing is the best and less complication and early reture to work it gives early weight bearing, no shortening, no delayed /non-union, no infection, early union and no malunion rom at ankle is very good rarely knee pain. Hence we conclude imil gives the best result.
In our study the fractures were operated by different surgeons. We fell a bigger randomised trial involving more number of cases will show how the imil is superior to the plates.