Minimally-Invasive Plate or Intramedullar Nail in the Management of Distal Extra-Articular Tibial Fracture, What is Better?

Objective: The aim of this study was to compare the clinical and functional outcomes of patients with distal tibia extraarticular fractures treated with Intramedullary nailing (IMN) or Minimally invasive plate osteosynthesis (MIPO). Materials and Methods: This retrospective study included 47 patients treated with IMN and 41 patients with MIPO. Clinical and radiographic results were evaluated at last follow-up. Anterior knee pain, American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale score and Lysholm knee scoring scale were used as clinical measurement. Results: Although the union time and operation time were significantly higher in the IMN group compared to the MIPO group (p<0.001), the full weight bearing time and the hospital time were higher in the MIPO group (p<0.001). There were no statistical differences between wound problem, malposition, infection and grafting rates in both groups (p>0.05). Although the AOFAS score was statistically higher in the IMN group (p=0.031), the Lysholm knee score was higher in the MIPO group (p<0.001). Conclusion: While MIPO is advantageous with low union time, low operating time and no damage to the knee joint, IMN allows earlier full weight bearing, lower hospitalization and has better ankle functional results. Keywords: