Intramedullary nail versus minimally invasive plate osteosynthesis for displaced extraarticular proximal tibia fractures: a prospective comparative cohort study.
Intramedullary nail
Minimally invasive plate osteosynthesis
Proximal tibia
Tibial fractures
Journal
European journal of orthopaedic surgery & traumatology : orthopedie traumatologie
ISSN: 1432-1068
Titre abrégé: Eur J Orthop Surg Traumatol
Pays: France
ID NLM: 9518037
Informations de publication
Date de publication:
Oct 2023
Oct 2023
Historique:
received:
16
10
2022
accepted:
05
02
2023
medline:
18
9
2023
pubmed:
6
4
2023
entrez:
5
4
2023
Statut:
ppublish
Résumé
The treatment of extraarticular proximal tibial fractures is challenging. As the optimal fixation technique is still debated, the purpose of this study was to compare minimally invasive plate osteosynthesis (MIPO) and intramedullary nail (IMN) fixation. A prospective matched comparative study was conducted on patients with displaced extraarticular proximal tibia fractures treated with MIPO (n = 29) versus IMN (n = 30) fixation. Outcomes collected were the Johner-Wruhs grading, range of motion (ROM), union rate, time to union, malunion, coronal and sagittal alignment, and post-operative complications. Union rates were similar between the MIPO and IMN groups (93% vs. 97%, P = 1.0). The IMN group had an earlier time to union (15 vs. 18 weeks, P < 0.001) and superior functional outcomes at one year (effective Johner-Wruhs score: 80% vs. 55%, P = 0.04). There was a significantly higher incidence of anterior knee pain in the IMN group (23% vs. 0%, P = 0.02) and there was a trend for more infections in the MIPO group (21% vs. 13%, P = 0.73). IMN fixation of extraarticular proximal tibia fractures was associated with a shorter union time and better functional scores compared to MIPO.
Identifiants
pubmed: 37020158
doi: 10.1007/s00590-023-03500-6
pii: 10.1007/s00590-023-03500-6
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3067-3079Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.
Références
Bono CM, Levine RG, Rao JP, Behrens FF (2001) Nonarticular proximal tibia fractures: treatment options and decision making. J Am Acad Orthop Surg 9:176–186. https://doi.org/10.5435/00124635-200105000-00004
doi: 10.5435/00124635-200105000-00004
pubmed: 11421575
Naik MA, Arora G, Tripathy SK, Sujir P, Rao SK (2013) Clinical and radiological outcome of percutaneous plating in extra-articular proximal tibia fractures: a prospective study. Injury 44:1081–1086. https://doi.org/10.1016/j.injury.2013.03.002
doi: 10.1016/j.injury.2013.03.002
pubmed: 23561582
Byun SE, Maher MH, Mauffrey C, Parry JA (2020) The standard sagittal starting point and entry angle for tibia intramedullary nails results in malreduction of proximal tibial fractures. Eur J Orthop Surg Traumatol 30:1057–1060. https://doi.org/10.1007/s00590-020-02669-4
doi: 10.1007/s00590-020-02669-4
pubmed: 32303842
Virkus WW, Kempton LB, Sorkin AT, Gaski GE (2018) Intramedullary Nailing of Periarticular Fractures. JAAOS-J Am Acad Orthop Surg 26:629–639
doi: 10.5435/JAAOS-D-16-00849
Nork SE, Schwartz AK, Agel J, Holt SK, Schrick JL, Winquist RA (2005) Intramedullary nailing of distal metaphyseal tibial fractures. J Bone Joint Surg Am 87:1213–1221. https://doi.org/10.2106/jbjs.C.01135
doi: 10.2106/jbjs.C.01135
pubmed: 15930529
Attal R, Hansen M, Kirjavainen M, Bail H, Hammer TO, Rosenberger R, Höntzsch D, Rommens PM (2012) A multicentre case series of tibia fractures treated with the expert tibia nail (ETN). Arch Orthop Trauma Surg 132:975–984. https://doi.org/10.1007/s00402-012-1502-y
doi: 10.1007/s00402-012-1502-y
pubmed: 22431141
Freedman EL, Johnson EE (1995) Radiographic analysis of tibial fracture malalignment following intramedullary nailing. Clin Orthop Relat Res 315:25–33
Beltran MJ, Collinge CA, Patzkowski JC, Masini BD, Blease RE, Hsu JR (2012) Intra-articular risks of suprapatellar nailing. Am J Orthop (Belle Mead NJ) 41:546–550
pubmed: 23550286
Ren C, Li M, Sun L, Li Z, Xu Y, Lu Y, Wang Q, Ma T, Xue H, Zhang K (2021) Comparison of intramedullary nailing fixation and percutaneous locked plating fixation for the treatment of proximal tibial fractures: a meta-analysis. J Orthop Surg (Hong Kong) 29:23094990211024396. https://doi.org/10.1177/23094990211024395
doi: 10.1177/23094990211024395
pubmed: 34231448
Harwood PJ, Newman JB, Michael ALR (2010) (ii) An update on fracture healing and non-union. Orthop Trauma 24:9–23. https://doi.org/10.1016/j.mporth.2009.12.004
doi: 10.1016/j.mporth.2009.12.004
Johner R, Wruhs O (1983) Classification of tibial shaft fractures and correlation with results after rigid internal fixation. Clin Orthop Relat Res 178:7–25
doi: 10.1097/00003086-198309000-00003
Bi Q, Zhu DJ, Qiu BS, Hong JF, Zhang SJ, Xia B (2007) Comparative study on treatment of midshaft tibial fracture with expandable and interlocking intramedullary nails. Chin J Traumatol 10:228–232
pubmed: 17651592
Wasky PR, Beltran MJ (2021) Extreme nailing or less invasive plating of lower extremity periarticular fractures. Orthop Clin North Am 52:111–121. https://doi.org/10.1016/j.ocl.2021.01.002
doi: 10.1016/j.ocl.2021.01.002
pubmed: 33752832
Weninger P, Tschabitscher M, Traxler H, Pfafl V, Hertz H (2010) Influence of medial parapatellar nail insertion on alignment in proximal tibia fractures–special consideration of the fracture level. J Trauma 68:975–979. https://doi.org/10.1097/TA.0b013e3181a4c1f0
doi: 10.1097/TA.0b013e3181a4c1f0
pubmed: 19826312
Meena RC, Meena UK, Gupta GL, Gahlot N, Gaba S (2015) Intramedullary nailing versus proximal plating in the management of closed extra-articular proximal tibial fracture: a randomized controlled trial. J Orthop Traumatol 16:203–208. https://doi.org/10.1007/s10195-014-0332-9
doi: 10.1007/s10195-014-0332-9
pubmed: 25588847
pmcid: 4559538
Belangero WD, Santos Pires RE, Livani B, Rossi FL, de Andrade ALL (2018) “Clothesline technique” for proximal tibial shaft fracture fixation using conventional intramedullary nail: a simple, useful, and inexpensive technique to prevent fracture malalignment. Eur J Orthop Surg Traumatol 28:721–725. https://doi.org/10.1007/s00590-018-2131-0
doi: 10.1007/s00590-018-2131-0
pubmed: 29362975
Franke J, Hohendorff B, Alt V, Thormann U, Schnettler R (2016) Suprapatellar nailing of tibial fractures-Indications and technique. Injury 47:495–501. https://doi.org/10.1016/j.injury.2015.10.023
doi: 10.1016/j.injury.2015.10.023
pubmed: 26553427
Jindal K, Neradi D, Sodavarapu P, Kumar D, Shetty A, Goni V (2021) Intramedullary nailing versus plating for proximal tibia fractures: a systematic review and meta-analysis. Indian J Orthop 55:582–594. https://doi.org/10.1007/s43465-020-00304-2
doi: 10.1007/s43465-020-00304-2
pubmed: 33995861
Krieg JC (2003) Proximal tibial fractures: current treatment, results, and problems. Injury 34(Suppl 1):A2-10. https://doi.org/10.1016/s0020-1383(03)00252-3
doi: 10.1016/s0020-1383(03)00252-3
pubmed: 14563005
Stannard JP, Wilson TC, Volgas DA, Alonso JE (2003) Fracture stabilization of proximal tibial fractures with the proximal tibial LISS: early experience in Birmingham, Alabama (USA). Injury 34(Suppl 1):A36-42. https://doi.org/10.1016/s0020-1383(03)00256-0
doi: 10.1016/s0020-1383(03)00256-0
pubmed: 14563009
Cheng L, Li YH, Chu Y, Yang G, Zhu D, Tan L (2021) Intramedullary nailing via suprapatellar approach versus locked plating of proximal extra-articular tibial fractures: a randomized control trial. Int Orthop 45:1599–1608. https://doi.org/10.1007/s00264-020-04821-5
doi: 10.1007/s00264-020-04821-5
pubmed: 32978652
Lindvall E, Sanders R, Dipasquale T, Herscovici D, Haidukewych G, Sagi C (2009) Intramedullary nailing versus percutaneous locked plating of extra-articular proximal tibial fractures: comparison of 56 cases. J Orthop Trauma 23:485–492. https://doi.org/10.1097/BOT.0b013e3181b013d2
doi: 10.1097/BOT.0b013e3181b013d2
pubmed: 19633457
Jain S, Verma R, Gaur D, Gohiya D (2016) To compare the outcome of intramedullary nailing and locking compression plate fixation in treatment of proximal one third tibia fracture: a randomized control trial. Int J Med Res Rev 4:245–253. https://doi.org/10.17511/ijmrr.2016.i02.020
doi: 10.17511/ijmrr.2016.i02.020
Maharaj D, Chand D (2018) Analysis of proximal plating versus intramedullary nailing in the treatment of extra-articular proximal tibial fractures. Int J Orthop Sci 4:363–368. https://doi.org/10.22271/ortho.2018.v4.i3g.62
doi: 10.22271/ortho.2018.v4.i3g.62
Anil P, Shailendra D, Maravi Deepak S, Uikey S (2019) Comparative analysis of closed reduction and expert tibia nailing and open reduction and plate & screw fixation in the treatment of proximal tibia extraarticular fractures. Int J Orthop Sci 5:328–332. https://doi.org/10.22271/ortho.2019.v5.i1f.59
doi: 10.22271/ortho.2019.v5.i1f.59
Gupta S, Rafeeq MD (2018) Comparison of intramedullary nailing versus proximal locking plating in the management of closed extra-articular proximal tibial fracture. Int J Res Orthop 4:480. https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20181802
doi: 10.18203/issn.2455-4510.IntJResOrthop20181802
Patel Z, Shah BB, Acharya H (2020) Extra-articular proximal tibia fractures: proximal tibia plate versus intramedullary nailing. J Indian Orthop Rheumatol Assoc 4(1):10–13. https://doi.org/10.18231/2455-6777.2018.0003
doi: 10.18231/2455-6777.2018.0003
Sharma AK, Aggarwal A (2016) Prospective comparative study of proximal third extra-articular tibial fractures treated with proximal lateral tibial locking plate and sirus intramedulary nail. Paripex-Indian J Res 5:150–153
Krettek C, Stephan C, Schandelmaier P, Richter M, Pape HC, Miclau T (1999) The use of poller screws as blocking screws in stabilising tibial fractures treated with small diameter intramedullary nails. J Bone Joint Surg Br 81:963–968. https://doi.org/10.1302/0301-620x.81b6.10000
doi: 10.1302/0301-620x.81b6.10000
pubmed: 10615966
Matthews DE, McGuire R, Freeland AE (1997) Anterior unicortical buttress plating in conjunction with an unreamed interlocking intramedullary nail for treatment of very proximal tibial diaphyseal fractures. Orthopedics 20:647–648. https://doi.org/10.3928/0147-7447-19970701-14
doi: 10.3928/0147-7447-19970701-14
pubmed: 9243676
Sadula Sharif P, Seyed Peyman M, Maryam S, Seyed Hadi K (2022) Femoral retrograde nailing, an excellent choice for femoral shaft fracture with scarce complications: educational corner. J Orthop Spine Trauma. https://doi.org/10.18502/jost.v7i4.8861
doi: 10.18502/jost.v7i4.8861
Tornetta P 3rd, Collins E (1996) Semiextended position of intramedullary nailing of the proximal tibia. Clin Orthop Relat Res 328:185–189. https://doi.org/10.1097/00003086-199607000-00029
doi: 10.1097/00003086-199607000-00029
Buehler KC, Green J, Woll TS, Duwelius PJ (1997) A technique for intramedullary nailing of proximal third tibia fractures. J Orthop Trauma 11:218–223. https://doi.org/10.1097/00005131-199704000-00014
doi: 10.1097/00005131-199704000-00014
pubmed: 9181507
Weninger P, Tschabitscher M, Traxler H, Pfafl V, Hertz H (2010) Intramedullary nailing of proximal tibia fractures—an anatomical study comparing three lateral starting points for nail insertion. Injury 41:220–225. https://doi.org/10.1016/j.injury.2009.10.014
doi: 10.1016/j.injury.2009.10.014
pubmed: 19880112
Tucker NJ, Hadeed MM, Mauffrey C, Parry JA (2022) Native tibia valga: a potential source of varus malreduction during intramedullary tibial nail fixation of tibial shaft fractures. Int Orthop 46:1165–1173. https://doi.org/10.1007/s00264-022-05356-7
doi: 10.1007/s00264-022-05356-7
pubmed: 35246719
Bhandari M, Audige L, Ellis T, Hanson B (2003) Operative treatment of extra-articular proximal tibial fractures. J Orthop Trauma 17:591–595. https://doi.org/10.1097/00005131-200309000-00013
doi: 10.1097/00005131-200309000-00013
pubmed: 14504586
Reddy MRS, Kumar N (2020) A comparative study of intramedullary nailing verus minimally invasive percutaneous plate osteosynthesis for extraarticular proximal tibia fracture: a prospective study. Int J Orthop Sci 6(1):606–610. https://doi.org/10.22271/ortho.2020.v6.i1k.1934
doi: 10.22271/ortho.2020.v6.i1k.1934