title: Treatment of distal tibial metaphyseal fractures: Plating versus shortened intramedullary nailing.
abstract: BACKGROUND
  Fractures in the distal tibial metaphysis are more complicated to treat than diaphyseal fractures. We compared treatment with plating to treatment with shorted intramedullary (IM) nailing.
  
  
  METHODS
  Patients with AO type 43A fractures were treated with plate fixation (group A, n=14) or shortened IM nailing (group B, n = 13). We compared postoperative radiographic deformities, functional results (Iowa ankle scores), and symptoms (Olerud and Molander ankle scores).
  
  
  RESULTS
  All fractures had healed at final follow-up (mean, 33 month). Mean union times were 27.8 week (range, 18-36 week) in group A and 22.6 week (range, 18-30 week) in group B (P<0.05). Mean postoperative valgus angulations were larger in group B (3.7 degrees ) than in group A (0.5 degrees ) (P<0.05). However, malunions did not differ between groups (P<0.05). Functional results and postoperative symptoms were similar.
  
  
  CONCLUSIONS
  Both plate fixation and shortened IM nailing were effective for treating distal tibial metaphyseal fractures.
authors.affiliation: Department of Orthopaedic Surgery, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaohsiung, Taiwan 813, ROC.
authors.forename: Shan-Wei
authors.initials: SW
authors.lastname: Yang
authors.forename: Huey-Ming
authors.initials: HM
authors.lastname: Tzeng
authors.forename: Yi-Jiun
authors.initials: YJ
authors.lastname: Chou
authors.forename: Hsiu-Peng
authors.initials: HP
authors.lastname: Teng
authors.forename: Hsin-Hua
authors.initials: HH
authors.lastname: Liu
authors.forename: Chi-Yin
authors.initials: CY
authors.lastname: Wong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D001860:Bone Plates; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*