How should open tibia fractures be treated? A retrospective comparative study between intramedullary nailing and biologic plating.
BACKGROUND
In this retrospective study, our purpose was to compare two treatment alternatives clinically.


METHODS
Forty-five patients who had grade I or II open tibia fractures were included. Twenty-five of them, treated via minimally invasive plate osteosynthesis (MIPO), comprised group I. The latter 20 cases, treated via partial reamed intramedullary nailing (PR-IMN), comprised group II. Clinical evaluation was made on the basis of modified Ketenjian's criteria.


RESULTS
Full weight-bearing periods in groups I and II were 21 and 22.4 weeks, respectively. Non-union in one case of group I was revised with circular fixator. In another case, implant removal was needed due to chronic osteomyelitis. Mal-union was detected in another. In group II, two cases needed implant revision with intramedullary nail in one and circular fixator in another for non-union. Mal-union in one case and chronic osteomyelitis in another were the late complications in group II. At the last follow-up, satisfaction rates were: 21/25 in group I and 18/20 in group II. There was no significant difference between groups (p>0.05).


CONCLUSIONS
The clinical results of both groups were similar. Although intramedullary nailing is the first choice, MIPO is an alternative method for open tibia fractures.
Kayali
Cemil
C
Department of Orthopaedics and Traumatology, Tepecik Training and Research Hospital, Izmir, Turkey. cemilkayali@yahoo.com
Ağuş
Haluk
H
Eren
Ahmet
A
Ozlük
Serkan
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D001858:Bone Nails; D001860:Bone Plates; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D005594:Fracture Fixation, Intramedullary / Q000379:methods; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000601:surgery*; D016896:Treatment Outcome; D016474:Weight-Bearing; D055815:Young Adult