Treatment of distal tibial metaphyseal fractures: Plating versus shortened intramedullary nailing.

BACKGROUND

Fractures in the distal tibial metaphysis are more complicated to treat than diaphyseal fractures. We compared treatment with plating to treatment with shorted intramedullary (IM) nailing.

METHODS

Patients with AO type 43A fractures were treated with plate fixation (group A, n=14) or shortened IM nailing (group B, n = 13). We compared postoperative radiographic deformities, functional results (Iowa ankle scores), and symptoms (Olerud and Molander ankle scores).

RESULTS

All fractures had healed at final follow-up (mean, 33 month). Mean union times were 27.8 week (range, 18-36 week) in group A and 22.6 week (range, 18-30 week) in group B (P<0.05). Mean postoperative valgus angulations were larger in group B (3.7 degrees ) than in group A (0.5 degrees ) (P<0.05). However, malunions did not differ between groups (P<0.05). Functional results and postoperative symptoms were similar.

CONCLUSIONS

Both plate fixation and shortened IM nailing were effective for treating distal tibial metaphyseal fractures.