Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
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Intramedullary Nailing versus Minimally Invasive Plate Osteosynthesis for Distal Tibia Shaft Fractures: Retrospective Comparison of Functional and Cosmetic Outcomes

경골 원위간부 골절 치료의 골수강내 금속정 고정술과 최소침습 금속판 고정술의 비교: 기능적, 미용적 결과의 후향적 비교

  • Kahyun Kim (Department of Orthopedic Surgery, National Police Hospital) ;
  • In Hee Kim (Department of Orthopedic Surgery, National Police Hospital) ;
  • Geon Jung Kim (Department of Orthopedic Surgery, National Police Hospital) ;
  • SungJoon Lim (Department of Orthopedic Surgery, National Police Hospital) ;
  • Ji Young Yoon (Department of Orthopedic Surgery, National Police Hospital) ;
  • Jong Won Kim (Department of Orthopedic Surgery, National Police Hospital) ;
  • Yong Min Kim (Department of Orthopedic Surgery, National Police Hospital)
  • Received : 2023.04.09
  • Accepted : 2023.06.16
  • Published : 2023.09.15
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Abstract

Purpose: This study compared the functional and cosmetic treatment outcomes of intramedullary nailing (IM nail) and minimally invasive plate osteosynthesis (MIPO) for distal tibia shaft fractures. Materials and Methods: Forty-eight patients with distal tibia shaft fractures (distal 1/3 of the diaphysis, AO/OTA [AO Foundation/Orthopaedic Trauma Association]) 43 managed by an IM nail (n=30) or MIPO (n=18) who had minimum one-year follow-up were enrolled in this study. The radiological, functional, and cosmetic outcomes in the two groups were compared retrospectively. Results: All patients achieved bone union. The mean bone union time of the IM nail and MIPO groups was 18.5 and 22.6 weeks, respectively (p=0.078). One patient in the MIPO group showed posterior angulation and valgus deformity of more than five degrees. The mean American Orthopaedic Foot and Ankle Society (AOFAS) functional scores were similar: 83.3 in the IM nail group and 84.6 in the MIPO group (p=0.289). The most salient difference was the cosmetic result of the surgical scar. The length of the scars around the ankle in the IM nail group was significantly smaller than the MIPO group (2.6 cm vs. 10.6 cm; p=0.035). The patient satisfaction survey of surgical scars revealed a significantly higher satisfaction rate in the IM nail group than in the MIPO group (93% vs. 44%; p<0.001). Conclusion: This study showed that both treatment methods for distal tibia shaft fractures have similar therapeutic efficacy regarding the radiological and functional outcomes. On the other hand, the IM nail technique showed superior cosmetic outcomes than the MIPO technique. IM nails may be more recommended in patients with high demand for cosmetic results.

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References

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