CLOSED TIBIAL FRACTURES

COMPARISON OF RADIOLOGICAL OUTCOME OF CLOSED INTERLOCK INTRAMEDULLARY NAILING VERSUS DYNAMIC COMPRESSION PLATING IN CLOSED TIBIAL FRACTURES

Abstract

Objectives: The objective is to compare the radiological outcome of closed
interlock intramedullary nailing versus dynamic compression plating in closed tibial fracture.
Study Design: Randomized controlled trials. Setting: Department of orthopedics Nishtar
Hospital Multan. Period: 9th July 2016 to March 2017. Methodology: There were 302 patients
divided in two equal groups of 151. Permission was taken from the ethical committee of Nishtar
Hospital. The 302 patients in age group 20-50 years of both genders meeting the inclusion
and exclusion criteria attending the outpatient clinic or admitted to the orthopedics department
through emergency were included in the study. All the data entered and analyzed using
computer software SPSS version 10. For quantitative variables like age and duration of fracture
mean and standard deviation was calculated. For categorical variables like gender, malunion
and infection frequency and percentage were calculated. Chi-square test was applied to
compare the malunion and infection in both groups. A p value 0.05 was considered statistically
significant. Results: The 100% (n=302) patients were divided into 2 groups equally, 151 in
each, i.e. intramedullary nail (group 1) and dynamic compression plating (group 2). The main
outcome variables of this study were the malunion and infection. It was observed that malunion
presented as 57% (n=86) and 70.9% (n=107) in group 1 and group 2 respectively. It was also
observed that infection presented as 23.2% (n=35) and 37.1% (n=56) in group 1 and group 2
respectively. After applying chi-square test, it was noted that malunion associated with groups
having p-value 0.012. But it was not associated with gender, stratified age and duration of
fracture having p-values 0.497, 0.800 and 0.218 respectively. Similarly, after applying chi-square
test, it was noted that infection associated with gender and groups having p-values 0.007 and
0.008 respectively. But it was not associated with stratified age and duration of fracture having
p-values 0.565 and 0.344 respectively. Conclusion: Closed interlock intramedullary nailing
has malunion and infection rates less than dynamic compression plating. So closed interlock
intramedullary nailing is preferred method of closed tibia diaphyseal fracture treatment.