title: Intramedullary nailing versus proximal plating in the management of closed extra-articular proximal tibial fracture: a randomized controlled trial.
abstract: BACKGROUND
  Extra-articular proximal tibial fractures account for 5-11 % of all tibial shaft fractures. In recent years, closed reduction and minimally invasive plating and multidirectional locked intramedullary nailing have both become widely used treatment modalities for proximal and distal tibial metaphyseal fractures. This study was performed to compare plating and nailing options in proximal tibia extra-articular fractures.
  
  
  METHODS
  This randomized prospective clinical study was conducted on 58 skeletally mature patients with a closed extra-articular fracture of the proximal tibia treated with minimally invasive proximal tibial plating (PTP) or intramedullary nailing (IMN) by trained surgeons at a tertiary trauma center.
  
  
  RESULTS
  Postoperative hospital stay (p = 0.035), time to full weight-bearing, and union time (p = 0.004) were significantly less in the IMN group than in the PTP group, but there was no clear advantage of either technique in terms of operative time (p = 0.082), infection rate (p = 0.738), range of motion of the knee (p = 0.462), or degrees of malunion and nonunion.
  
  
  CONCLUSIONS
  Both implants have shown promising results in extra-articular proximal tibial fractures, and provide rigid fixation that prevents secondary fracture collapse.
  
  
  METHODS
  Level 2, randomized controlled trial.
authors.affiliation: Department of Orthopaedics, SMS Medical College and Hospital, Jaipur, 302004, India, rc.meena@yahoo.com.
authors.forename: Ramesh Chand
authors.initials: RC
authors.lastname: Meena
authors.forename: Umesh Kumar
authors.initials: UK
authors.lastname: Meena
authors.forename: Gopal Lal
authors.initials: GL
authors.lastname: Gupta
authors.forename: Nitesh
authors.initials: N
authors.lastname: Gahlot
authors.forename: Sahil
authors.initials: S
authors.lastname: Gaba
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001858:Bone Nails; D001860:Bone Plates; D005260:Female; D005594:Fracture Fixation, Intramedullary; D017102:Fracture Healing; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013978:Tibial Fractures / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult