[A comparisive study between intramedullary interlocking nail and plate-screw fixation in the treatment of tibial shaft fractures].
OBJECTIVE
To evaluate the effects of tibial shaft fractures treatment with plate-screw or intramedullary interlocking nail.


METHODS
Thirty-five fractures were treated with intramedullary interlocking nail. Tape A, B and C were 11, 18 and 6 cases respectively according to AO classification. Forty-five fractures were treated with plate-screw system. Type A,B and C were 10,22 and 13 cases respectively. The mean time between injury and operation was 3 days and 3.5 days respectively. The patients were evaluated with operation time,range of motion,time of bone union,and complications after a mean followup of 13 months(range 8 to 26 months).


RESULTS
The mean operation time and the mean range of motion of the ankle and knee were found similar in both groups. The average dorsiflexion angle of ankle was 13 Degrees (0 degrees to 20 degrees) in locked intramedullary nailing group and 11 degrees (0 degree to 20 degrees) in plate group. The average plantar flextion angle of ankle was 41 degrees (30 degrees to 50 degrees) in locked intramedullary nailing group and 47 degrees (30 degrees to 50 degrees) in plate-screw group. The mean time of bone union was 3.3 months with intramedullary nailing and 3.5 months with plate-screw fixation. Length discrepancy occurred in only two patients (2 and 2.5 cm) with intramedullary interlocking nail. One patient treated by intramedullary interlocking nail for a type III open fracture occured osteomyelitis. Plain radiographs showed rotation in two patients with intramedullary interlocking nail and angulation in 3 patients with plate-screw fixation, which were distal-third tibial fractures.


CONCLUSIONS
Plate-screw osteosynthesis could attain satisfactory results in uncomminuted tibia shaft fractures, and locked intramedullary nailing is more appropriate in comminuted fractures.
Huang
Peng
P
Department of Orthopaedics, PLA General Hospital, Beijing 100853, China.
Tang
Pei-fu
PF
Yao
Qi
Q
Liang
Yu-tian
YT
Tao
Sheng
S
Zhang
Qun
Q
Guo
Yi-zhu
YZ
Liang
Xiang-dang
XD
Wang
Yan
Y
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; D013978:Tibial Fractures / Q000601:surgery*