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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

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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
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:
DateEvent
May 2012Published
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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