Comparison of plaque and Distally-Wedged Tibial Nail in the treatment of extraarticular distal tibia fractures

INTRODUCTION: Tibial fractures are encountered in many age-groups. Depending on fracture type and pattern, many types of treatment options including plate fixation, intramedullary fixation, circular external fixation are widely used. Depending on implant design, surgical approach could be various and be jeopardised.In this study, we wish to evaluate the benefits and negative sides between plate and distally-wedged tibial nail fixation.
METHODS: Between 2013 and 2016 (in Van Regional, Education and Research Hospital, Türkiye) 38 patients (25 male, 13 female patients: ages range 18 to 61 years, mean age is 41) treated surgically using distally-wedged tibial nail fixation (amount: 16) and plate fixation (amount: 22). The patients were evaluated by AOFAS score (documentated 1.5 and 6 months postoperatively), postop hospitalisation days, perop fluouruscopy imaging (scopy shooting) times and union time (months). Average follow-up time was 11 months (range: 9 to 28 months).
RESULTS: There was a shorter recovery period in the nail group and the hospital stay was shorter. (P <0.001)
The AOFAS score was higher at 1.5 months postoperatively and the number of scopies was higher at 1.5 months olds (p <0.001) No sigficiant difference were found in postoperative 6th month AOFAS score between plate and nailing groups.
DISCUSSION AND CONCLUSION: We have found and concluded that DSBLS(Distal Supportive Bolt Locking Screw) screw of this tibial nailing fixation system could provide distal interlocking strong enough especially when fracture is quite close to the distal tibial articular face,using distally wedged tibial nails and componenet.