title: Comparison of intramedullary nail and plate fixation in distal tibia diaphyseal fractures close to the mortise.
abstract: BACKGROUND
  In this study, we aimed to compare the functional and radiological results of intramedullary nailing and plate fixation techniques in the surgical treatment of distal tibia diaphyseal fractures close to the ankle joint.
  
  
  METHODS
  Between 2005 and 2011, 55 patients (32 males, 23 females; mean age 42 years; range 15 to 72 years) who were treated with intramedullary nailing (21 patients) or plate fixation (34 patients) due to distal tibia diaphyseal fracture were included in the study. The average follow-up period was 27.6 months (range, 12-82 months). The patients were evaluated with regard to nonunion, malunion, infection, and implant irritation. The AOFAS (American Orthopaedic Foot and Ankle Society) scale was used for the clinical evaluation.
  
  
  RESULTS
  No statistically significant difference was found between the two surgical methods with respect to unification time, AOFAS score, accompanying fibula fracture, material irritation, and malunion. Nine patients had open fractures, and these patients were treated with plate fixation (p=0.100). Nonunion developed in three patients who were treated with plates. Infection occurred in one patient. Anterior knee pain was significantly higher in patients who were treated with intramedullary nails. There was no malunion in any patient.
  
  
  CONCLUSIONS
  As the distal fragment is not long enough, plate fixation technique is usually preferred in the treatment of distal tibia diaphyseal fractures. In this study, we observed that if the surgical guidelines are followed carefully, intramedullary nailing is an appropriate technique in this kind of fracture. The malunion rates are not significantly increased, and it also has the advantages of being a minimally invasive surgery with fewer wound problems.
authors.affiliation: Department of Orthopaedics and Traumatology, MS Baltalimanı Bone Diseases Training and Research Hospital, İstanbul, Turkey. umut78@yahoo.com.
authors.forename: Umut
authors.initials: U
authors.lastname: Yavuz
authors.affiliation: Department of Orthopaedics and Traumatology, MS Baltalimanı Bone Diseases Training and Research Hospital, İstanbul, Turkey.
authors.forename: Sami
authors.initials: S
authors.lastname: Sökücü
authors.affiliation: Department of Orthopaedics and Traumatology, MS Baltalimanı Bone Diseases Training and Research Hospital, İstanbul, Turkey.
authors.forename: Bilal
authors.initials: B
authors.lastname: Demir
authors.affiliation: Department of Orthopaedics and Traumatology, MS Baltalimanı Bone Diseases Training and Research Hospital, İstanbul, Turkey.
authors.forename: Timur
authors.initials: T
authors.lastname: Yıldırım
authors.affiliation: Department of Orthopaedics and Traumatology, MS Baltalimanı Bone Diseases Training and Research Hospital, İstanbul, Turkey.
authors.forename: Cağrı
authors.initials: C
authors.lastname: Ozcan
authors.affiliation: Department of Orthopaedics and Traumatology, MS Baltalimanı Bone Diseases Training and Research Hospital, İstanbul, Turkey.
authors.forename: Yavuz Selim
authors.initials: YS
authors.lastname: Kabukçuoğlu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D064386:Ankle Fractures / Q000601:surgery; D001858:Bone Nails; D001860:Bone Plates; D002648:Child; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects* / Q000379:methods*; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult