scholarly journals Comparison of electromyographic activity of quadriceps muscle in persons with unilateral traumatic transtibial amputation using patellar tendon bearing supracondylar endoskeletal prosthesis with the unaffected limb in weight bearing positions.

2021 ◽  
pp. 1-5
Author(s):  
Dipti Naik ◽  
Vaibhav Dolas
Keyword(s):  
Patellar Tendon ◽  
Surface Electromyography ◽  
Weight Bearing ◽  
Quadriceps Muscle ◽  
Electromyographic Activity ◽  
Unaffected Side ◽  
Transtibial Amputation ◽  
Bipedal Stance ◽  
Prosthetic Limb ◽  
Significant Difference

Abstract Purpose: comparison of electromyographic activity of quadriceps muscle in persons with unilateral traumatic transtibial amputation using patellar tendon bearing supracondylar endoskeletal prosthesis with the unaffected limb in weight bearing positions. Method: 30 individuals  aged 18-60 years were assessed using surface electromyography with functional level K3 according to K-level functional assessment scale to compare the activity of quadriceps of affected side using patellar tendon bearing supracondylar endoskeletal prosthesis with the unaffected side. The data was analysed using paired t-test. Result:  There was a significant difference in the activity of VMO and VLO muscles of the quadriceps in high sitting positions. There was also a significant difference in the activity of VMO muscle in single limb stance and bipedal stance. However, there was no significant difference between the activity of VLO muscle in bipedal stance but there was reduced activity of VLO muscle in the prosthetic limb in single limb stance. Conclusion: The quadriceps activity was reduced in the affected limb in high sitting position, single  limb stance and bipedal stance. However, no difference in the muscle activity was noted in VLO muscle in bipedal stance. Keywords: trans tibial amputation, patellar tendon bearing supracondylar prosthetis, surface electromyography. 

scholarly journals Static versus dynamic prosthetic weight bearing in elderly trans-tibial amputees

1997 ◽  
Vol 21 (2) ◽  
pp. 100-106 ◽  
Author(s):  
M. E. Jones ◽  
J. R. Steel ◽  
G. M. Bashford ◽  
I. R. Davidson
Keyword(s):  
Weight Bearing ◽  
Gait Training ◽  
Standing Position ◽  
Prosthetic Limb ◽  
Significant Difference ◽  
Reaction Forces ◽  
Peak Weight ◽  
Static Versus Dynamic ◽  
Vertical Ground Reaction Forces ◽  
Medical Fitness

The purpose of this study was to compare prosthetic weight-bearing tolerance in the standing position to the dynamic vertical ground reaction forces (VGRF) experienced during walking in elderly dysvascular trans-tibial amputees. Ten unilateral trans-tibial amputees attending an amputee clinic (mean age =67±6.5 years) were selected as subjects. Selection criteria were the level of amputation, age, medical fitness to participate and informed consent. Each participant completed five trials of standing (static) weight bearing measurement followed by 10 walking (dynamic) trials on a 10m level walkway, five trials for each limb. Static weight bearing (SWB) was measured using standard bathroom scales. Dynamic weight bearing (DWB) was measured during gait using a Kistler multichannel force platform. T-tests for dependent means indicated that the forces borne in prosthetic single limb stance (mean=0.97±0.03 times body weight (BW)) were significantly lower than the forces borne by the prosthetic limb during the first peak (weight acceptance) VGRF (mean = 1.08±0.08 BW; t = −4.999; p = 0.001) and significantly higher than the midstance VGRF (mean = 0.82±0.07 BW; t = 5.401; p<0.001). However, there was no significant difference between SWB and the second peak (push-off) VGRF generated by the prosthetic limb during walking (mean = 0.96±0.03 BW). It was concluded that clinical gait training may utilise SWB as a guide to an amputees' prosthetic weight bearing tolerance and requirements during walking.

scholarly journals Comparison of Electromyographic Activity of Anterior Tibial Muscles and Long Fibular in Athletes With and Without Chronic Ankle Instability

2020 ◽  
Vol 22 (4) ◽  
pp. 260-264
Author(s):  
Giovanna Piai Cezar ◽  
Barbara Pasqualino Fachin ◽  
Christiane de Souza Guerino Macedo
Keyword(s):  
Surface Electromyography ◽  
Ankle Instability ◽  
Functional Limitation ◽  
Chronic Ankle Instability ◽  
Control Group ◽  
Electromyographic Activity ◽  
Ankle Sprains ◽  
Muscle Recruitment ◽  
Significant Difference ◽  
Anterior Tibial

AbstractChronic ankle instability (ICT) is common in jumping sports, may alter muscle recruitment, result in functional limitations and recurrence of sprains in this joint. The purpose of the study was to compare the muscle recruitment of the anterior tibial and long fibular muscles of athletes with and without chronic ankle instability by means of surface electromyography. Thirty-four athletes were recruited, divided into instability group (GI: n=14) and control group (GC: n=20), of both sexes and from different sport modalities, aged between 18 and 27 years old, history of ankle sprain in the last 12 months and functional limitation established by the Cumberland Ankle Instability (CAIT) questionnaire, the recruitment of the anterior tibial and long fibular muscles was analyzed by surface electromyography during the lunge exercise. The results for GI and GC were, respectively: age 21.3±2.88 and 22.4±3.25, height 1.77±0.10 and 1.74±0.08, CAIT 17[12.2-19] and 29.5 [27-30] (p<0.001). The anterior tibial and long fibular muscle recruitment in GI was 111.1[62.5-165.4] and 68.2±29, respectively and in GC 106.8[79.8-230.5] and 54.4±26.4, without significant difference. ICT did not interfere in the recruitment of the anterior tibial and long fibular muscles during the lunge exercise in athletes. Keywords: Ankle. Sprains and Strains. Health Evaluation. ResumoA instabilidade crônica do tornozelo (ICT) é comum em esportes de saltos, pode alterar o recrutamento muscular, resultar em limitações funcionais e recidivas de entorses nesta articulação. O objeto do estudo foi comparar o recrutamento muscular dos músculos tibial anterior e fibular longo de atletas com e sem instabilidade crônica de tornozelo por meio da eletromiografia de superfície. Foram recrutados 34 atletas, divididos em grupo instabilidade (GI: n=14) e grupo controle (GC: n=20), de ambos os sexos e de diferentes modalidades esportivas, com idade entre 18 e 27 anos, história de entorse de tornozelo nos últimos 12 meses e limitação funcional estabelecida pelo questionário Cumberland Ankle Instability (CAIT), o recrutamento dos músculos tibial anterior e fibular longo foi analisado pela eletromiografia de superfície durante o exercício de agachamento afundo. Os resultados para GI e GC foram, respectivamente: idade 21,3±2,88 e 22,4±3,25, altura 1,77±0,10 e 1,74±0,08, CAIT 17[12,2–19] e 29,5 [27-30] (p<0,001). O recrutamento muscular do tibial anterior e fibular longo no GI foi 111,1[62,5-165,4] e 68,2±29, respectivamente e no GC 106,8[79,8-230,5] e 54,4±26,4, sem diferença significativa. A ICT não interferiu no recrutamento dos músculos tibial anterior e fibular longo durante a realização do exercício de agachamento afundo em atletas. Palavras-chave: Tornozelo. Entorses e Distensões. Avaliação em Saúde

scholarly journals Patellar Tendon Properties and Lower Limb Function in Rheumatoid Arthritis and Ankylosing Spondylitis versus Healthy Controls: A Cross-Sectional Study

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Verena Matschke ◽  
Jeremy G. Jones ◽  
Andrew B. Lemmey ◽  
Peter J. Maddison ◽  
Jeanette M. Thom
Keyword(s):  
Rheumatoid Arthritis ◽  
Ankylosing Spondylitis ◽  
Physical Function ◽  
Patellar Tendon ◽  
Time Course ◽  
Repair Process ◽  
Quadriceps Muscle ◽  
Healthy Controls ◽  
Cross Sectional ◽  
Significant Difference

Objective. Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) lead to inflammation in tendons and peritendinous tissues, but effects on biomechanical tendon function are unknown. This study investigated patellar tendon (PT) properties in stable, established RA and AS patients.Methods. We compared 18 RA patients (13 women, 59.0 ± 2.8 years, mean ± SEM) with 18 age- and sex-matched healthy controls (58.2 ± 3.2 years), and 12 AS patients (4 women, 52.9 ± 3.4 years) with 12 matched controls (54.5 ± 4.7 years). Assessments with electromyography, isokinetic dynamometry, and ultrasound included quadriceps muscle force and cross-sectional area (CSA), PT stiffness, and PT CSA. Additionally, measures of physical function and disease activity were performed.Results. PT stiffness and physical function were lower in RA and AS patients compared to healthy controls, without a significant difference in force production. PT CSA was significantly larger leading to reduction in Young’s modulus (YM) in AS, but not in RA.Conclusion. The adverse changes in PT properties in RA and AS may contribute to their impaired physical function. AS, but not RA, leads to PT thickening without increasing PT stiffness, suggesting that PT thickening in AS is a disorganised repair process. Longitudinal studies need to investigate the time course of these changes and their response to exercise training.

scholarly journals MRI Evaluation of Patella Alignment Before and After Anatomical Reconstruction of ACL Undergoing Unified Rehabilitation Programme Introduced by CMC Physical Therapy Team

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0014
Author(s):  
Dariusz Straszewski ◽  
Marcin Plenzler ◽  
Joanna Szczepaniak ◽  
Robert Śmigielski ◽  
Beata Ciszkowska-Łysoń ◽  
...  
Keyword(s):  
Patellar Tendon ◽  
Muscle Activation ◽  
Weight Bearing ◽  
Tendon Graft ◽  
Rehabilitation Programme ◽  
Anatomical Reconstruction ◽  
Patella Baja ◽  
Functional Rehabilitation ◽  
Patellar Tendon Graft ◽  
The Impact

Objectives: The aim of the study was to asses the impact of the functional rehabilitation on patella alignment with MRI imaging in patients who underwent the ACL reconstruction. The surgical approach with the use of patellar tendon graft is known to carry the risk of lowering patella height (patella baja), which, in turn, may lead to accelerated cartilage wear in patellofemoral joint. Methods: 30 patients after the anatomical reconstruction of ACL took part in this study (23 male, and 7 female, mean age = 28 ± 10,6 years). During the procedure a patellar tendon graft was used. The Insali-Salvati ratio measured with MRI (images taken pre-procedural, and 9 months after the surgery) was used for the assessment of patellar alignment. The measurements were taken by one radiology specialist on MRI scans in sagittal view in PD sequence. During the examination, patellar joint was in flexion (approx.10 degrees). As the point of reference for patella’s position ISR ratio was in the range of 0.8 - 1.2. All patients were operated on by the same team of surgeons and underwent an unified rehabilitation programme led by a team of selected physiotherapists. The main features of the programme were: an early muscle activation (second day after the procedure); mobilisation of the patella and tissues of the anterior compartment of the knee; weight bearing co-contraction exercises, and the sensomotoric training of the entire kinetic chain of the lower limb. The data recorded was statistically analysed using the Wilcoxon signed-rank test in order to establish parameters’ changes within the study group.. Results: The mean ISR value before the procedure was 0.84 (± 0,1), whereas 9 months after the surgery it was 0.85 (± 0,1). The results’ analysis did not show any statistically significant changes between ISR values. Nine months after the procedure patella baja has not been observed in any of the evaluated patients. Conclusion: The functional rehabilitation programme designed by the CMC team had no negative impact on patella alignment, as no patella baja, which is a common complication after these kinds of surgeries, has been observed. The applied functional rehabilitation programme enabled patients to keep the proper patella alignment, similar to the alignment recorded before the surgery.

Continuous Femoral Nerve Blockade versus Continuous Epidural Analgesia for Postoperative Pain Relief in Knee Surgeries

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hala Gomaa Salama ◽  
Ahmed Ali El- Shebiny ◽  
Abd Al Aziz Abdullah Abd Al Aziz ◽  
Mariam Mahmoud Ahmed Ali Shehata
Keyword(s):  
Postoperative Pain ◽  
Epidural Analgesia ◽  
Nerve Block ◽  
Femoral Nerve Block ◽  
Weight Bearing ◽  
Femoral Nerve ◽  
Disease Process ◽  
Continuous Epidural Analgesia ◽  
Significant Difference ◽  
Continuous Femoral Nerve Block

Abstract Background The progression of osteoarthritis is characteristically slow, occurring over several years or decades. Over this period, the patient can become less and less active and thus more susceptible to morbidities related to decreasing physical activity (including potential weight gain). Early in the disease process, the joints may appear normal. However, the patient’s gait may be antalgic if weight-bearing joints are involved. Objective Compare the benefits of continuous femoral nerve block (CFNB) with those of continuous epidural analgesia CEPA for postoperative pain management after Knee surgeries. Methods This study is a randomized controlled clinical trial was conducted in Ain Shams University Hospitals after obtaining approval from the Research Ethical Committee of Ain Shams University during a period of three months. Patients undergoing primary unilateral TKA for osteoarthritis, were recruited at least one day prior to the scheduled surgery, male and female patients. Results There was significant difference in terms of pain scoring between continuous femoral nerve block (CFNB) and continuous epidural analgesia (CEA) in the first 6 hours, 12 hours, 24 hours, 48 hours, 72 hours but non significant difference in incidence of side effects Conclusion Our study showed that CEA had optimal analgesia and pain control than CFNB in management of post operative pain after total knee replacement.

scholarly journals Objective assessment of stiffness in Achilles tendinopathy: a novel approach using the MyotonPRO

2018 ◽  
Vol 4 (1) ◽  
pp. e000446 ◽  
Author(s):  
Gafin Ericson Morgan ◽  
Rhodri Martin ◽  
Lisa Williams ◽  
Owen Pearce ◽  
Keith Morris
Keyword(s):  
Dynamic Stiffness ◽  
Objective Assessment ◽  
Weight Bearing ◽  
Achilles Tendinopathy ◽  
Control Group ◽  
Asymptomatic Group ◽  
Musculotendinous Junction ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

ObjectivesThe aim of this study was to establish quantitative values for asymptomatic and symptomatic Achilles tendons.DesignCohort study with a single (cross-sectional) time point of patients diagnosed with unilateral Achilles tendinopathy and an asymptomatic group with comparative homogeneity.MethodsA sample of 50 participants: 25 diagnosed with symptomatic unilateral Achilles tendinopathy (AT group) and 25 with asymptomatic Achilles tendons (control group 2). The asymptomatic side of the AT group was used as a control (control group 1). Measurements at 2 cm intervals on the tendon from its insertion at the calcaneum up to the musculotendinous junction were taken non-weight bearing (NWB) and weight bearing (WB) using the MyotonPRO.ResultsThere was a significant (p<0.005) decrease in natural oscillation frequency (F) at points 2, 3 and 4 of the AT group (NWB condition) and points 2 and 3 for the WB condition. There was a significant (p<0.005) increase in logarithmic decrement (D) at points 2 and 3 signifying a decrease in elasticity. Dynamic stiffness (S) was significantly (p<0.005) reduced in the AT group at points 2 and 3 WB and point 3 WB. There was no significant difference in creep (C) observed between the symptomatic and asymptomatic tendons. There was a significant (p<0.005) increase in mechanical stress relaxation time (R) at point 2 NWB.There was a correlation between body weight and gender on tendon mechanics, with the symptomatic tendons. No significant differences were observed between the control group 1 and control group 2.ConclusionsThe MyotonPRO measured decreased stiffness over a section of the tendon corresponding clinically with Achilles tendinopathy. This may have potential in identifying risk of injury and informing rehabilitation, however further extensive research is required to generate baseline data for specific population groups monitoring variables over time. Age, gender and body mass index appear to have some bearing on the mechanical properties of the tendon but mainly in the tendinopathy group.

scholarly journals Radiographic Recurrence of Hallux Valgus Based on Osteotomy Location

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0021
Author(s):  
Andrew Federer ◽  
Travis Dekker ◽  
David Tainter ◽  
Jordan Liles ◽  
Mark Easley ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Weight Bearing ◽  
Surgical Correction ◽  
P Value ◽  
Single Individual ◽  
Hallux Valgus Angle ◽  
Intermetatarsal Angle ◽  
Valgus Angle ◽  
Significant Difference

Category: Bunion Introduction/Purpose: Hallux valgus (HV) is one of the most common deformities of the foot resulting in pain and lifestyle modification of the patient. Recurrence rates of 10-47% have been documented in single individual osteotomy series. Unfortunately, surgical correction and recurrence are often defined as changes related to normal radiographs and not actually as the magnitude of correction lost with follow-up. Currently there have not been studies evaluating the percentage of recurrence of intermetatarsal angle (IMA) and hallux valgus angle (HVA). As there is substantial difference in starting IMA and HVA, as well as amount of surgical correction, our goal was to evaluate the percentage loss of correction over time comparing preoperative, initial postoperative and minimum of 2-year follow up radiographs among three different surgical correction techniques. Methods: This is a retrospective chart review study that examines the weight-bearing radiographic measurements of patients undergoing hallux valgus corrective surgery at a single institution over 5 years. Fifty-three patients were divided into first tarsometatarsal arthrodesis (i.e. Lapidus), mid-diaphyseal osteotomies (i.e. scarf), and distal metatarsal osteotomies (i.e. chevron). The preoperative, initial postoperative, and final follow up weight-bearing radiographs were measured for intermetatarsal angle (IMA) and hallux valgus angle (HVA). Primary outcome was percentage of recurrence of IMA and HVA, with the difference in angles between preoperative and initial postoperative weight-bearing films being considered 100% correction. The percentage of recurrence between initial postoperative and most recent follow up was then calculated (Figure 1A). A one-way analysis of variance (ANOVA) test and post-hoc Tukey-Kramer tests were used to compare preoperative IMA and HVA and percentage recurrence of IMA and HVA at most recent follow up. Results: There was no significant difference between Lapidus (14.3deg) and mid-diaphyseal osteotomies (12.7deg) in preoperative IMA (p-value=0.26). There was a significant difference between Lapidus (-0.3deg) and mid-diaphyseal (2.8deg) osteotomies for degree of hallux valgus recurrence as measured by IMA between initial postoperative films and final 2-year follow up (p-value=0.009). Lapidus procedure showed a greater magnitude decrease in IMA degrees from preoperation to final follow up compared to distal osteotomy (p-value=0.037) and trended toward significance compared to mid-diaphyseal (p-value=0.056). Mid-diaphyseal osteotomies (30%) showed a statistically significant higher percentage of IMA recurrence compared to Lapidus (-11%) (p-value=0.0014) (Figure 1B). When comparing percentage recurrence of HVA, distal osteotomies had a significantly smaller rate of recurrence when compared to the diaphyseal osteotomies (p-value=0.030). Conclusion: Though Lapidus and mid-diaphyseal osteotomies were performed for patients with a similar preoperative IMA, mid-diaphyseal osteotomies had a significantly higher percentage of recurrence at 2-year follow up compared to Lapidus procedures. Moreover, Lapidus procedures trended toward greater overall of IMA correction compared to mid-diaphyseal osteotomies. When either a Lapidus or mid-diaphyseal osteotomy is indicated, a Lapidus procedure may result in decreased rate of radiographic recurrence of hallux valgus at 2 years.

scholarly journals Morpho-textural changes of the patellar tendon in professional volleyball players: a six month longitudinal study

2019 ◽  
Vol 02 (02) ◽  
pp. 126-126
Author(s):  
de Groot Ferrando A.
Keyword(s):  
Patellar Tendon ◽  
Effect Size ◽  
Repeated Measures ◽  
Structural Changes ◽  
Patellar Tendinopathy ◽  
Average Effect ◽  
Average Effect Size ◽  
Significant Difference ◽  
Volleyball Players ◽  
Textural Changes

Abstract Introduction Tendinopathy is a term used to describe a clinical presentation of pain and dysfunction, which, at times, is accompanied by pathologic structural changes in the tendon matrix. Jumper's knee has been studied for some time, however the etiology is still unknown. The deep fibers of the proximal region are the most affected area in tendinopathies affecting the patellar tendon. Ultrasound (US) scanning may have the greatest sensitivity for confirming clinically diagnosed patellar tendinopathy compared with other imaging techniques such as magnetic resonance. Some studies have found that a minimum of six months is required to observe significant structural changes, although other studies reveal that structural changes can be visible in a shorter period of time. Thus, sonography has been used to evaluate quantitative variables such as thickness, echogenicity, texture measures and the internal tendon matrix. Objective The purpose of this study was to evaluate the sonographic behavior of morpho-textural changes of the patellar tendon in professional male volleyball players over a one year season. Material and Methods This is an observational, longitudinal and analytical study. A sample of 66 patellar tendons from 33 volleyball players of the Spanish super league was recruited, with an average of: 28 years, 86kg and 192cm. An ultrasound scan was performed using the Sonosite Titan ultrasound system, L38, 5–10 MHz, with a cross section of 5mm from the lower pole of the patella. Two depths were analyzed: a.39mm: echogenicity, echogenicity variation, circularity, width and thickness. b.24mm: entropy and contrast. Statistical analysis and analysis of variance (ANOVA) was performed for repeated measures and, in addition, the effect size was calculated with Cohen's d. The confidence interval was 95%. SPSS Statistics software was used. Results For textural variables: contrast increased significantly with an average effect size, and entropy showed no significant difference. Circularity was significantly lower. Width was shown to be significantly greater, with an average effect size, while thickness was reduced significantly. Regarding echogenicity, no significant changes were detected and variation in echogenicity did not show significant changes. Conclusions Imaging analysis could be a potential tool to detect changes in the pattern of patellar tendons. Some morpho-textural changes were found in male volleyball players: the textural contrast variable increases significantly throughout the annual season, meaning that the tendon becomes slightly flatter and loses circularity in its transverse section. The entropy and echogenic parameters obtained from the gray-scale histogram did not reveal any significant changes.

Retention of Hindlimb Stepping Ability in Adult Spinal Cats After the Cessation of Step Training

1999 ◽  
Vol 81 (1) ◽  
pp. 85-94 ◽  
Author(s):  
R. D. De Leon ◽  
J. A. Hodgson ◽  
R. R. Roy ◽  
V. R. Edgerton
Keyword(s):  
Weight Bearing ◽  
Activity Patterns ◽  
Motor Task ◽  
Full Weight Bearing ◽  
Electromyographic Activity ◽  
Locomotor Training ◽  
Neural Pathways ◽  
Step Cycle ◽  
Rapid Learning ◽  
Hindlimb Muscle

de Leon, R. D., J. A. Hodgson, R. R. Roy, and V. R. Edgerton. Retention of hindlimb stepping ability in adult spinal cats after the cessation of step training. J. Neurophysiol. 81: 85–94, 1999. Adult spinal cats were trained to perform bipedal hindlimb locomotion on a treadmill for 6–12 wk. After each animal acquired the ability to step, locomotor training was withheld, and stepping was reexamined 6 and 12 wk after training ended. The performance characteristics, hindlimb muscle electromyographic activity patterns, and kinematic characteristics of the step cycle that were acquired with training were largely maintained when training was withheld for 6 wk. However, after 12 wk without training, locomotor performance declined, i.e., stumbling was more frequent, and the ability to consistently execute full weight-bearing steps at any treadmill speed decreased. In addition, the height that the paw was lifted during the swing phase decreased, and a smaller range of extension in the hindlimbs occurred during the E3 phase of stance. When three of the spinal cats underwent 1 wk of retraining, stepping ability was regained more rapidly than when trained initially. The finding that stepping ability in trained adult spinal cats can persist for 6 wk without training provides further evidence that training-induced enhancement of stepping is learned in the spinal cats and that a memory of the enhanced stepping is stored in the spinal networks. However, it appears that the spinal cord can forget how to consistently execute stepping if that task is not practiced for 12 wk. The more rapid learning that occurred with retraining is also consistent with a learning phenomenon. These results in conjunction with our earlier findings suggest that the efficacy of the neural pathways that execute a motor task is highly dependent on the periodic activation of those pathways in a sequence compatible with that motor task.

scholarly journals Distal Tibia Metaphyseal Fractures: Which is Better, Intra-medullary Nailing or Minimally Invasive Plate Osteosynthesis?

2018 ◽  
Vol 24 (1) ◽  
pp. 66-71
Author(s):  
Kawalkar Abhijit Chandrakant ◽  
Badole Chandrashekher Martand
Keyword(s):  
Intramedullary Nailing ◽  
Weight Bearing ◽  
Distal Tibia ◽  
Tibial Fractures ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Early Weight Bearing ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Tibia Fractures ◽  
Distal Tibia Fractures

Introduction Tibia fractures are the most common long bone fractures encountered by the orthopedic surgeons and distal tibia fractures have the second highest incidence of all tibia fractures after the middle third of tibia the distal tibial fractures are unique and are considered as most challenging fractures to treat due to its proximity to the ankle joint and its superficial nature. The objective of this study is to compare two osteosynthesis systems developed for surgical treatment of distal tibia fractures: the intramedullary nailing and the MIPPO technique. Methods The study was conducted between Jan 2011 to Dec 2012. 63 patients with extra-articular distal tibia fracture treated with intramedullary nailing and MIPPO technique were reviewed retrospectively and clinical outcome was evaluated according to American Orthopaedic Foot and Ankle Score. Results 31 patients were treated with intramedullary nail & 32 with MIPPO technique. Fibular fixation was done in cases where fibular fracture was at or below the level of tibial fractures. We found no difference in terms of time for fracture union, mal-union, non-union, duration of surgery and amount of blood loss. But there was significant difference in terms of infection and duration of hospital stay. Also weight bearing was possible much earlier in intramedullary group as compared to the MIPPO group. Conclusion Thus we conclude that intramedullary nailing is better choice of implant in patients with extra- articular distal tibia fractures & helps in early weight bearing and ambulation of patient with fewer complications.

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