| Summary: | Introduction: Tibia fractures are the most common long bone fractures encountered by the orthopedic surgeons and distal tibia fractures have the second highest incidence of all tibia fractures after the middle third of tibia the distal tibial fractures are unique and are considered as most challenging fractures to treat due to its proximity to the ankle joint and its superficial nature. The objective of this study is to compare two osteosynthesis systems developed for surgical treatment of distal tibia fractures: the intramedullary nailing and the MIPPO technique. Methods: The study was conducted between Jan 2011 to Dec 2012. 63 patients with extra-articular distal tibia fracture treated with intramedullary nailing and MIPPO technique were reviewed retrospectively and clinical outcome was evaluated according to American Orthopaedic Foot and Ankle Score. Results: 31 patients were treated with intramedullary nail & 32 with MIPPO technique. Fibular fixation was done in cases where fibular fracture was at or below the level of tibial fractures. We found no difference in terms of time for fracture union, mal-union, non-union, duration of surgery and amount of blood loss. But there was significant difference in terms of infection and duration of hospital stay. Also weight bearing was possible much earlier in intramedullary group as compared to the MIPPO group. Conclusion: Thus we conclude that intramedullary nailing is better choice of implant in patients with extra- articular distal tibia fractures & helps in early weight bearing and ambulation of patient with fewer complications. 中 文 摘 要: 引言：脛骨骨折是骨科醫生遇到的最常見的長骨骨折；脛骨骨折中，遠端骨折比較中段三分之一骨折的發生率少，居第二位。由於其接近踝關節及其表面位置，脛骨遠端骨折是獨特的，被認為是治療難度最大的骨折。 本研究的目的是比較兩種脛骨遠端骨折內固定手術治療：髓內釘和微創鋼板內固定(MIPP) 技術。方法：回顧性分析2011年1月至2012年12月間的63例脛骨遠端骨折髓內釘和MIPPO技術治療。根據美國骨科足踝評分標準，對患者的臨床資料評價。結果：31例患者採用髓內釘治療，32例採用MIPPO技術。當腓骨骨折處於或低於脛骨骨折水平的情況下，進行腓骨固定。 我們發現骨折癒合時間、畸形癒合、不癒合率、手術時間和失血量沒有差異。 但感染率和住院時間差異有統計學意義。 與MIPPO組相比，髓內組可以更早負重。結論：因此，我們認為髓內釘是關節外脛骨遠端骨折患者更好的選擇，有助於患者早期負重和移動和較少並發症。 Keywords: distal tibia metaphyseal fracture, interlocking nail, minimally invasive plate osteosynthesis
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