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Comparison of low, multidirectional locked nailing and plating in the treatment of distal tibial metadiaphyseal fractures

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Abstract

Purpose

The aim of this study was to compare the results of a new technique for low, multidirectional locked nailing with closed reduction and minimally invasive plating in the treatment of distal tibial metadiaphyseal fractures.

Methods

Forty-six matched patients were divided according to age, gender, Injury Severity Score, and fracture pattern into group A (expert tibial nailing) and group B (minimally invasive plating). Then, the patients were followed up, and the clinical and radiographic results were retrospectively analysed.

Results

The mean followed-up was 24.7 ± 2.7 months in group A and 25.8 ± 2.8 months in group B. No patient had nonunion, shortening, hardware breakdown, or deep-seated infection. Patients in group A had a significantly shorter mean operating time, hospital stay, full weight-bearing time and union time (76 ± 16.6 vs. 90 ± 20.3 minutes, p = 0.000; 5.8 ± 2.1 vs. 8.9 ± 3.1 days, p = 0.000; 9.0 ± 1.4 vs. 11.1 ± 1.7 weeks, p = 0.000; and 21.3 ± 3.5 vs. 23.1 ± 3.6 weeks, p = 0.047, respectively). Three patients in group A and one patient in group B presented with malalignment (p = 0.608). The mean Olerud-Molander Ankle score was 89.0 ± 7.1 in group A and 87.6 ± 8.4 in group B (p = 0.478).

Conclusions

Distal tibia metadiaphyseal fractures may be treated successfully with low, multidirectional locked nails or plates. However, low, multidirectional locked nailing may represent a superior surgical option, since it offers advantages in terms of mean operating time, hospital stay, full weight-bearing time and union time.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, West China Hospital of Sichuan University, No.37, Guo-xue-xiang, Chengdu, 610041, People’s Republic of China

    Yong Li, Lei Liu, Xin Tang, Fuxing Pei, Guanglin Wang, Yue Fang & Hui Zhang

  2. Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China

    Nicolas Crook

Authors
  1. Yong Li
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  2. Lei Liu
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  3. Xin Tang
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  4. Fuxing Pei
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  5. Guanglin Wang
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  6. Yue Fang
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  7. Hui Zhang
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  8. Nicolas Crook
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Correspondence to Lei Liu.

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Li, Y., Liu, L., Tang, X. et al. Comparison of low, multidirectional locked nailing and plating in the treatment of distal tibial metadiaphyseal fractures. International Orthopaedics (SICOT) 36, 1457–1462 (2012). https://doi.org/10.1007/s00264-012-1494-9

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  • DOI: https://doi.org/10.1007/s00264-012-1494-9

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