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Intramedullary Nailing Versus Plating for Proximal Tibia Fractures: A Systematic Review and Meta-analysis

  • Review Article
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Indian Journal of Orthopaedics Aims and scope Submit manuscript

Abstract

Introduction

Extra-articular proximal tibia fractures make up to one-tenth of all tibia shaft fractures. Treatment options include conservative, nailing, plating and external fixation. There is no consensus on which method is superior if the patient is to be managed surgically.

Materials and Methods

We conducted a systematic review and meta-analysis to know which definitive surgical treatment option (nailing or plating) is better for extra-articular proximal tibia fracture. We used search engines like PubMed, Embase, Scopus, Ovid Medline and Google Scholar to find articles comparing the results of nailing versus plating. We could identify only 4 articles regarding this and data was extracted and meta-analysis was done.

Results

Delayed union was common in the nailing group with odds ratio of 8.29 favoring the plating group (95% CI 1.77, 38.80, p = 0.007) while malunion showed no difference in both groups. Rate of infection was higher in the plating group while anterior knee pain was common in the nailing group with odds ratio of 5.54 favoring the plating group (95% CI 1.49, 13.88, p = 0.008). Range of motion showed no difference between both groups, fractures in the nailing group united early and the difference was significant (p = 0.005, odds ratio  – 4.48) (95% CI  – 8.29,  – 1.47).The surgical duration was less in the nailing group but was not significant.

Conclusion

Considering lesser time for union, early weight bearing, lower chances of infection and lesser surgical duration, nailing seems to be more promising for extra articular proximal tibia fractures. Further research is required on this topic to provide a definitive evidence.

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Authors and Affiliations

  1. Department of Orthopaedics, PGIMER, Chandigarh, India

    Karan Jindal, Deepak Neradi, Praveen Sodavarapu, Deepak Kumar, Akshay Shetty & Vijay Goni

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  1. Karan Jindal
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  2. Deepak Neradi
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  3. Praveen Sodavarapu
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  4. Deepak Kumar
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  5. Akshay Shetty
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  6. Vijay Goni
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Correspondence to Deepak Neradi.

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Jindal, K., Neradi, D., Sodavarapu, P. et al. Intramedullary Nailing Versus Plating for Proximal Tibia Fractures: A Systematic Review and Meta-analysis. JOIO 55, 582–594 (2021). https://doi.org/10.1007/s43465-020-00304-2

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