comparison between unreamed locked intramedullary nailing and plate-screw fixation in the treatment of tibial diaphyseal fractures

ABSTRACT

Tibial diaphyseal fracture is the most common fracture of long bones. In Iran plating and un-dreamed tibial nailing [UTN] are the most commonly used methods and because of paucity of equipments such as c-arm and reaming sets, the reamed method is rarely used. This study compares these two methods. In a randomized clinical trial study including 100 patients [78 males, 22 females; mean age=24 years; range=16-50 years] undergoing UTN and plate-screw in the treatment of uncomminuted closed tibial shaft fractures [50 patients in each group] were compared regarding the union time and complications after a mean follow up of 16 months [12-20 months]. the mean time to union was 16 weeks with UTN and 14.3 weeks with plate-screw fixation. There was 4 [8%] and 3 [6%] non unions after UTN and plating respectively. Plain radiographs in both groups showed angu-lation in 3 patients; all in distal third and in varus [6%]. There was not any infection after UTN but one case of superficial and one case of deep infection were noticed after osteosynthesis with plate and screw [4%]. Four patients after UTN and 4 patients after fixation with plate-screw required reoperation [8%]. plate-screw osteosynthesis yielded satisfactory results in uncomminuted closed fractures of the tibial shaft comparable with UTN results: