• Atilla Polat, Ozkan Kose, Kerem Canbora, Serhat Yanık, and Ferhat Guler.
• Department of Orthopaedics and Traumatology, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey.
• J Orthop Sci. 2015 Jul 1; 20 (4): 695-701.

PurposeThe purpose of this randomized clinical trial is to compare intramedullary nailing (IMN) versus minimally invasive plate osteosynthesis (MIPO) for the treatment of extra-articular distal tibial shaft fractures.Materials And MethodsTwenty-five consecutive patients with distal extra-articular tibial fractures which were located between 4 and 12 cm from the tibial plafond (AO 42A1 and 43A1) were randomly assigned into IMN (n: 10) or MIPO (n: 15) treatment groups. All patients were followed for at least 1 year. Foot function index, time to weight bearing, union time, duration of operation, length of incision, intra-operative blood loss, intra-operative fluoroscopy time, rotational and angular malalignment, rate of infection, secondary interventions and complications were compared between groups.ResultsAll patients completed the trial and were followed with a mean of 23.1 ± 9.4 months (range 12-52). Foot function index, weight bearing time, union time, rate of malunion, rate of infection and rate of secondary interventions were all similar between groups (p = 0.807, p = 0.177, p = 0.402, p = 0.358, p = 0.404, p = 0.404, respectively). Intra-operative blood loss, length of surgical incision, radiation time and rotational malalignment were higher in the IMN group (p = 0.012, p = 0.019, p = 0.004 and p = 0.027, respectively).ConclusionsResults of our study showed that both treatment methods have similar therapeutic efficacy regarding functional outcomes and can be used safely for extra-articular distal tibial shaft fractures, and none of the techniques had a major advantage over the other.

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