title: [Locked plating with minimally invasive percutaneous plate osteosynthesis versus intramedullary nailing of distal extra-articular tibial fracture: a retrospective study].
abstract: OBJECTIVE
  To compare the efficacies of minimally invasive plate osteosynthesis (MIPPO) and interlocking intramedullary nailing (IMN) in the treatment of extra-articular fractures of distal tibia.
  
  
  METHODS
  Retrospective reviews were conducted for 126 patients with extra-articular distal tibia fractures. Treatment was either MIPPO (n = 61) or IMN (n = 65). The outcomes were assessed by comparing operating duration, time to union, the last follow-up American Orthopedic Foot and Ankle Society (AOFAS) score and complication rate.
  
  
  RESULTS
  The average follow-up period was 23.7 (12-53) months. In the minimally invasive plate osteosynthesis group, there were deep infections (n = 2), superficial infections (n = 5), delayed union (n = 2), malunion (n = 2) and knee joint pain (n = 10) were observed. In addition, the average operating duration (85.9 ± 18.9 min), average time to union (17.3 ± 3.8 weeks) and average AOFAS (83.2 ± 11.9) were analyzed. In the interlocking intramedullary nailing group, there were delayed union (n = 3), malunion (n = 12) and knee joint pain (n = 22). And the average operating duration (83.3 ± 15.7 min), average time to union (16.5 ± 3.1 weeks) and average AOFAS (84.9 ± 12.0) were analyzed. No statistical significance existed in operating duration, time to union and the last follow-up AOFAS between two groups (P > 0.05). However, the rates of malformation and knee joint pain were higher in the intramedullary nail group than those in the plate group. And the difference was statistically significant (P = 0.015, P = 0.025).
  
  
  CONCLUSIONS
  Both MIPPO and IMN are effective for extra-articular fractures of distal tibia. However, the former has the advantage of lowers rate of malformation and knee joint pain. Therefore a surgeon should consider the degree of injury while managing extra-articular fracture of distal tibia.
authors.affiliation: Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Yao
authors.affiliation: Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Ni
authors.affiliation: Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.
authors.forename: Li-bin
authors.initials: LB
authors.lastname: Peng
authors.affiliation: Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.
authors.forename: Da-xin
authors.initials: DX
authors.lastname: Yu
authors.affiliation: Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China. Email: yqjh2010@163.com.
authors.forename: Xiao-ming
authors.initials: XM
authors.lastname: Yuan
mesh_terms: D000328:Adult; D000368:Aged; D001858:Bone Nails; D001860:Bone Plates; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D017102:Fracture Healing; D006801:Humans; D016268:Internal Fixators; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000601:surgery*; D016896:Treatment Outcome