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A randomised pilot trial of "locking plate" fixation versus intramedullary nailing for extra-articular fractures of the distal tibia
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Mauffrey, C., McGuinness, K., Parsons, Nicholas R., Achten, Juul and Costa, Matthew L. (2012) A randomised pilot trial of "locking plate" fixation versus intramedullary nailing for extra-articular fractures of the distal tibia. Journal of Bone and Joint Surgery - British Volume, Volume 94-B (Number 5). pp. 704-708. doi:10.1302/0301-620X.94B5.28498 ISSN 0301-620X.
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Official URL: http://dx.doi.org/10.1302/0301-620X.94B5.28498
Abstract
The ideal form of fixation for displaced, extra-articular fractures of the distal tibia remains controversial. In the UK, open reduction and internal fixation with locking-plates and intramedullary nailing are the two most common forms of treatment. Both techniques provide reliable fixation but both are associated with specific complications. There is little information regarding the functional recovery following either procedure.
We performed a randomised pilot trial to determine the functional outcome of 24 adult patients treated with either a locking-plate (n = 12) or an intramedullary nailing (n = 12). At six months, there was an adjusted difference of 13 points in the Disability Rating Index in favour of the intramedullary nail. However, this was not statistically significant in this pilot trial (p = 0.498). A total of seven patients required further surgery in the locking-plate group and one in the intramedullary nail group.
This study suggests that there may be clinically relevant, functional differences in patients treated with nail versus locking-plate fixation for fractures of the distal tibia and differences in related complications. Further trials are required to confirm the findings of this pilot investigation.
| Item Type: | Journal Article | ||||
|---|---|---|---|---|---|
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit |
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| Journal or Publication Title: | Journal of Bone and Joint Surgery - British Volume | ||||
| Publisher: | British Editorial Society of Bone and Joint Surgery | ||||
| ISSN: | 0301-620X | ||||
| Official Date: | May 2012 | ||||
| Dates: |
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| Volume: | Volume 94-B | ||||
| Number: | Number 5 | ||||
| Page Range: | pp. 704-708 | ||||
| DOI: | 10.1302/0301-620X.94B5.28498 | ||||
| Status: | Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Restricted or Subscription Access | ||||
| Funder: | AO Foundation Project | ||||
| Grant number: | S-07-4C |
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