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Treatment of distal tibial fractures: prospective comparative study evaluating two surgical procedures with investigation for predictive factors of unfavourable outcome

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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.

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.

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 (p = 0.271). 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 (p = 0.019). At multivariate analysis, no variables showed a predictive power for unfavourable outcome.

Conclusions

Clinical and radiological results of LP and IMN appear similar. No predictive factors of unfavourable outcome were identified.

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Authors and Affiliations

  1. Orthopedic Clinic, University Hospital of Parma, Via Gramsci 14, 43100, Parma, Italy

    Enrico Vaienti, Paolo Schiavi, Francesco Ceccarelli & Francesco Pogliacomi

Authors
  1. Enrico Vaienti
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  2. Paolo Schiavi
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  3. Francesco Ceccarelli
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  4. Francesco Pogliacomi
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Corresponding author

Correspondence to Paolo Schiavi.

Ethics declarations

The Local Research Ethics Service approved the study, which was conducted following the principles of Declaration of Helsinki. All patients signed informed consent.

Conflict of interest

The authors declare that they have no conflict of interest.

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Vaienti, E., Schiavi, P., Ceccarelli, F. et al. Treatment of distal tibial fractures: prospective comparative study evaluating two surgical procedures with investigation for predictive factors of unfavourable outcome. International Orthopaedics (SICOT) 43, 201–207 (2019). https://doi.org/10.1007/s00264-018-4121-6

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  • DOI: https://doi.org/10.1007/s00264-018-4121-6

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