Comparison of intramedullary nailing and minimal invasive plate osteosynthesis in the treatment of simple intra-articular fractures of the distal tibia (AO-OTA type 43 C1-C2)

Objective: The aim of this study was to compare midterm functional and radiographic results of minimal invasive plate osteosynthesis (MIPO) with intramedullary nailing (IMN) of simple intra-articular distal tibial fractures (AO-OTA type 43 C1-C2). Methods: Seventy-three simple intra-articular distal...

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Main Authors: Ozan Beytemür, Alican Barış, Cem Albay, Serdar Yüksel, Sever Çağlar, Ender Alagöz
Format: Article
Language:English
Published: AVES 2017-01-01
Series:Acta Orthopaedica et Traumatologica Turcica
Online Access:http://www.sciencedirect.com/science/article/pii/S1017995X16301870
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author Ozan Beytemür
Alican Barış
Cem Albay
Serdar Yüksel
Sever Çağlar
Ender Alagöz
author_facet Ozan Beytemür
Alican Barış
Cem Albay
Serdar Yüksel
Sever Çağlar
Ender Alagöz
author_sort Ozan Beytemür
collection DOAJ
description Objective: The aim of this study was to compare midterm functional and radiographic results of minimal invasive plate osteosynthesis (MIPO) with intramedullary nailing (IMN) of simple intra-articular distal tibial fractures (AO-OTA type 43 C1-C2). Methods: Seventy-three simple intra-articular distal tibial fracture patients were evaluated retrospectively. All were treated between 2009 and 2014. The average age of the patients was 40.3 years. Thirty-seven patients were treated with IMN and 36 patients were treated with MIPO. Fibular plate osteosynthesis was applied in 5 cases (13.5%) in the IMN group and in 23 patients (63.9%) in the MIPO group. Results: Functional results and complications of IMN and MIPO methods were assessed in 73 patients. The average union time was 16.4 ± 2.7 weeks in the IMN group and 15.2 ± 1.8 weeks in the MIPO group (p = 0.079). The average Olerud-Molander Ankle Score was 87.8 ± 8.1 in the IMN group and 81.5 ± 11.8 in the MIPO group (p = 0.013). Four patients in the IMN group experienced valgus malunion, while it was not observed in any patients in the MIPO group (p = 0.042). Recurvatum malunion was detected in 10 patients in the MIPO group and not seen in the IMN group (p = 0.001). Ankle dorsiflexion angle was 25.8 ± 4.5° in the IMN group and 33.3 ± 8.9° in the MIPO group (p = 0.000). Conclusion: Simple intra-articular distal tibial fractures are successfully treated with IMN and MIPO. Prevalence of valgus malunion was higher in the IMN group and recurvatum was more prevalent in the MIPO group. MIPO is the first preference according to the literature; however, successful results have been obtained with IMN in this fracture pattern. Level of Evidence: Level III, Therapeutic Study. Keywords: Distal tibial fractures, Intra-articular fractures, Intramedullary nailing, Minimally invasive plate osteosynthesis, Minimally invasive surgery
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series Acta Orthopaedica et Traumatologica Turcica
spelling doaj-art-b8668aebdad34f6cbcf0ac723482aeae2025-08-20T03:57:43ZengAVESActa Orthopaedica et Traumatologica Turcica1017-995X2017-01-01511121610.1016/j.aott.2016.07.010Comparison of intramedullary nailing and minimal invasive plate osteosynthesis in the treatment of simple intra-articular fractures of the distal tibia (AO-OTA type 43 C1-C2)Ozan Beytemür0Alican Barış1Cem Albay2Serdar Yüksel3Sever Çağlar4Ender Alagöz5Bağcılar Training and Research Hospital, Department of Orthopedics and Traumatology, İstanbul, Turkey; Corresponding author. Fax: +90 212 440 40 00.İstanbul Training and Research Hospital, Department of Orthopedics and Traumatology, İstanbul, TurkeyBağcılar Training and Research Hospital, Department of Orthopedics and Traumatology, İstanbul, TurkeyBağcılar Training and Research Hospital, Department of Orthopedics and Traumatology, İstanbul, TurkeyBağcılar Training and Research Hospital, Department of Orthopedics and Traumatology, İstanbul, TurkeyBağcılar Training and Research Hospital, Department of Orthopedics and Traumatology, İstanbul, TurkeyObjective: The aim of this study was to compare midterm functional and radiographic results of minimal invasive plate osteosynthesis (MIPO) with intramedullary nailing (IMN) of simple intra-articular distal tibial fractures (AO-OTA type 43 C1-C2). Methods: Seventy-three simple intra-articular distal tibial fracture patients were evaluated retrospectively. All were treated between 2009 and 2014. The average age of the patients was 40.3 years. Thirty-seven patients were treated with IMN and 36 patients were treated with MIPO. Fibular plate osteosynthesis was applied in 5 cases (13.5%) in the IMN group and in 23 patients (63.9%) in the MIPO group. Results: Functional results and complications of IMN and MIPO methods were assessed in 73 patients. The average union time was 16.4 ± 2.7 weeks in the IMN group and 15.2 ± 1.8 weeks in the MIPO group (p = 0.079). The average Olerud-Molander Ankle Score was 87.8 ± 8.1 in the IMN group and 81.5 ± 11.8 in the MIPO group (p = 0.013). Four patients in the IMN group experienced valgus malunion, while it was not observed in any patients in the MIPO group (p = 0.042). Recurvatum malunion was detected in 10 patients in the MIPO group and not seen in the IMN group (p = 0.001). Ankle dorsiflexion angle was 25.8 ± 4.5° in the IMN group and 33.3 ± 8.9° in the MIPO group (p = 0.000). Conclusion: Simple intra-articular distal tibial fractures are successfully treated with IMN and MIPO. Prevalence of valgus malunion was higher in the IMN group and recurvatum was more prevalent in the MIPO group. MIPO is the first preference according to the literature; however, successful results have been obtained with IMN in this fracture pattern. Level of Evidence: Level III, Therapeutic Study. Keywords: Distal tibial fractures, Intra-articular fractures, Intramedullary nailing, Minimally invasive plate osteosynthesis, Minimally invasive surgeryhttp://www.sciencedirect.com/science/article/pii/S1017995X16301870
spellingShingle Ozan Beytemür
Alican Barış
Cem Albay
Serdar Yüksel
Sever Çağlar
Ender Alagöz
Comparison of intramedullary nailing and minimal invasive plate osteosynthesis in the treatment of simple intra-articular fractures of the distal tibia (AO-OTA type 43 C1-C2)
Acta Orthopaedica et Traumatologica Turcica
title Comparison of intramedullary nailing and minimal invasive plate osteosynthesis in the treatment of simple intra-articular fractures of the distal tibia (AO-OTA type 43 C1-C2)
title_full Comparison of intramedullary nailing and minimal invasive plate osteosynthesis in the treatment of simple intra-articular fractures of the distal tibia (AO-OTA type 43 C1-C2)
title_fullStr Comparison of intramedullary nailing and minimal invasive plate osteosynthesis in the treatment of simple intra-articular fractures of the distal tibia (AO-OTA type 43 C1-C2)
title_full_unstemmed Comparison of intramedullary nailing and minimal invasive plate osteosynthesis in the treatment of simple intra-articular fractures of the distal tibia (AO-OTA type 43 C1-C2)
title_short Comparison of intramedullary nailing and minimal invasive plate osteosynthesis in the treatment of simple intra-articular fractures of the distal tibia (AO-OTA type 43 C1-C2)
title_sort comparison of intramedullary nailing and minimal invasive plate osteosynthesis in the treatment of simple intra articular fractures of the distal tibia ao ota type 43 c1 c2
url http://www.sciencedirect.com/science/article/pii/S1017995X16301870
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