International Orthopaedics

, Volume 42, Issue 4, pp 915–919 | Cite as

Extra-articular distal tibia fractures—controversies regarding treatment options. A single-centre prospective comparative study

  • Mihail-Lazar Mioc
  • Radu Prejbeanu
  • Bogdan Deleanu
  • Bogdan Anglitoiu
  • Horia Haragus
  • Marius Niculescu
Original Paper


Distal tibia fractures are reported to have a high complication rate pre-operatively as well as post-operatively, which can include open fractures, soft tissue damage, infection, malalignment, pseudarthrosis and ankle arthrosis. The operative treatment for the extra-articular distal tibia fractures is a controversial topic in the orthopaedic literature. Some of these fractures are proximal enough to be treated with an intramedullary nail while others are too distal for that. The aim of our study was to compare the results we have had with intramedullary nail (IMN) and minimally invasive plate osteosynthesis (MIPO) in distal metaphyseal (extra-articular) tibia fractures. The study was designed prospectively between January 2013 and March 2016 and took place on the Orthopaedics and Traumatology ward of a Clinical Emergency County Hospital in western Romania. The follow-up visits were scheduled one month, three months and six months post-operatively. For evaluating the ankle function, we used the Olerud–Molander ankle score (OMAS) and union was evaluated at six months on ankle X-rays. At the six-month follow-up visit the average scores were 75.55 (20-100) for the IMN lot and 74.23 (20-90) for the MIPO lot, without finding any statistical difference between the two groups (p >0.1). At the six-month follow-up, X-ray union was objected in 48 (90.5%) of our patients, the IMN lot having worse results (85.18%) than the MIPO lot (96.15%). The results we encountered showed little to no statistical difference when it comes to the functional score we used (OMAS score), leading us to believe that you can achieve comparable results with both implants.


Distal tibia fracture Intramedullary nail MIPO plating Functional outcome Complication rates 



Not applicable.


There is no funding source

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest to declare.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the SCJU Pius Branzeu Research Committee and with the 1964 Helsinki declaration and its later amendments.


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Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  • Mihail-Lazar Mioc
    • 1
  • Radu Prejbeanu
    • 2
  • Bogdan Deleanu
    • 2
  • Bogdan Anglitoiu
    • 2
  • Horia Haragus
    • 2
  • Marius Niculescu
    • 3
  1. 1.Pius Branzeu Emergency Clinical County HospitalTimisoaraRomania
  2. 2.Victor Babes University of Medicine and PharmacyTimisoaraRomania
  3. 3. Faculty of MedicineTitu Maiorescu UniversityBucharestRomania

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