Distal Tibia Fractures Intramedullary Nail Vs MIPPO Technique

OBJECTIVE: The objective of this clinical analysis is to compare two osteosynthesis systems developed for surgical treatment of distal tibia fractures: the intramedullary nail and Mippo technique.MATERIALS AND METHODS: The study was conducted from August 2006 to April 2008 at First affiliated hospital of DMU. This can be defined as comparison between the intramedullary and extramedullary (plate) fixation systems.74 patients were included, 33 in group-A and 41 in group-B. Age of the patients was ranging from 22 to 87. 15 females and 59 men were included. According to AO classification 2 were A2.1,21 were type A2.2,2 were A2.3, 3 type A3.2 , 1 type B1.3, 2 type B2.1, 23 type B2.2, 18 type B2.3 , 2 type C1.1 . All the patients were followed up for 12 months, both clinically and radiologically. Operation duration, intra-op bleeding, post-op drainage, weight bearing time and the time taken for radiological union are used in analysis. Patient's medical status, antibiotic duration, duration of hospital stay, range of motion in both knee and ankle were evaluated.RESULT: All the patients achieved bony union. We found both the systems are near same as far as operation duration and blood loss concerned but statistical difference was found with the time taken for radiological union (P<0.05). Post-operative pain was well tolerated in patients with IMN. Bony union was found on the radiograph with IMN by 18 weeks and with MIPPO at 22.7 weeks, at an average.CONCLUSION: IMN is the choice of implant in the treatment of distal tibia fractures particularly for comminuted and for osteoporotic bone. It is also the choice of treatment for the open fractures with less soft tissue coverage.