title: [A comparison between locked intramedullary nailing and plate-screw fixation in the treatment of tibial diaphysis fractures].
abstract: OBJECTIVE
  The results of treatment with plate-screw or locked intramedullary nailing were evaluated for tibial diaphysis fractures, with a comparison of time to union and complications.
  
  
  METHODS
  The study included 44 patients (31 males, 13 females; mean age 38 years; range 14 to 64 years) with tibial diaphysis fractures. The fractures were on the left side in 23 patients and on the right side in 20 patients. One patient had bilateral involvement. Twenty-six fractures were treated by intramedullary nailing and 19 fractures by plate-screw fixation after a mean time of nine days and 10 days from injury, respectively. The patients were evaluated with regard to operation time, range of motion, time to union, and complications after a mean follow-up of 23 months (range 18 to 46 months).
  
  
  RESULTS
  The mean operation time and the mean range of motion of the ankle and knee were found similar in both groups. The mean time to union was five months with intramedullary nailing, and 3.5 months with plate-screw fixation. Length discrepancy occurred in only two patients (2 and 2.5 cm) in whom intramedullary nailing was performed. One patient treated by intramedullary nailing for a type III open fracture developed osteomyelitis. Plain radiographs showed angulation in four patients and in three patients following intramedullary nailing and plate-screw fixation, respectively, all of whom had distal-third tibial fractures.
  
  
  CONCLUSIONS
  Plate-screw osteosynthesis yields satisfactory results in uncomminuted fractures of the tibial diaphysis, whereas locked intramedullary nailing is more appropriate in comminuted fractures because of better preservation of periosteal circulation, and thus lower complication rates.
authors.affiliation: Department of Orthopedics and Traumatology, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey. bombacih@hotmail.com
authors.forename: Hasan
authors.initials: H
authors.lastname: Bombaci
authors.forename: Bülent
authors.initials: B
authors.lastname: Güneri
authors.forename: Mücahit
authors.initials: M
authors.lastname: Görgeç
authors.forename: Adnan
authors.initials: A
authors.lastname: Kafadar
mesh_terms: D000293:Adolescent; D000328:Adult; D001858:Bone Nails; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011859:Radiography; D016059:Range of Motion, Articular; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome