Are clinical and functional results of MIPPO and IMN for treatment of extraarticular distal tibia fractures similar?

Abstract

Aim: Controversy still exists on whether intramedullary nailing (IMN) or minimal invasive percutaneous osteosynthesis (MIPPO) is better for treatment of extra-articular distal tibia fractures. In this study, our aim was to retrospectively compare the clinical and functional results of patients with distal tibia fractures that were treated f by plate or nail. Material and Methods: This study included 46 patients with a mean age of 40,3 (range, 18-63 years). All had closed extra-articular distal tibia fractures within 4 to 10 cm away from the tibial plafond and two senior trauma surgeons operated them with either MIPPO (n=27) or IMN (n=19) technique. Patients were followed up until full bony union occurred and also hospitalization time, union time, malunion criteria; complication rates and AOFAs were evaluated. Results: Mean follow up was 12.5 (range, 10-16 months) months and no major vessel injury or deep infection was observed in either group. Full bony union time was similar in two groups (15±12.7 weeks in MIPPO and 16±11.3 weeks in IMN group; p=0.062). Also, there was not statistically significant difference in MIPPO and IMN groups for nonunion rates [3 (11%) vs. 1 (5.3%)] and malunion rates 3 (11.1%) vs. 2 (10.5%)] (p>0.05). However, secondary surgical intervention was performed in two patients (7.4%) of MIPPO group for severe wound dehiscence (p=0.04). Conclusion: The two surgical techniques are equivocal for nonunion or malunion rates. However, wound problems may be seen after MIPPO technique and surgeon must be cautious for applying plate when patient has apparent wound problem.