Ankle Arthrodesis Nail Combined with Locking Compression Plate to Stabilize Two-Level Pathologic Tibial Fractures

Aim and objectives:to compare both the ways of xation in randomly selected cases in distal third tibia fractures to known the best way of xation technique & implant. Material and methods: In our study we have selected 40 patients with fractures of the distal third tibia, who attended the department of orthopaedics treated by open reduction and internal xation with using Medial/Lateral distal locking compression plates, in Mahatma Gandhi Medical College & Hospital, Jaipur during the year January 2019 to June 2020. The duration of follow-up to evaluate result was six months. We divided the distal leg bone fractures into two groups. Group 1: Include the distal third tibial fractures which are simple or comminuted treated as open reduction & internal xation with lateral locking compression plate. Group 2: Includes the distal third tibial fractures which are simple or comminuted, treated as open reduction & internal xation with medial locking compression plate. Results: There was no signicant difference in duration of surgeries and suture removal.In there were 3 cases of nonunion 1 case in lateral plating group and 2 cases in medial plating group. Group 1 were show 20% excellent, 45% good, 30% fair & 5% poor result. Group 2 were show 15 % excellent, 30% good, 45% fair &10% poor result according to Tenny & Wiss criteria. Conclusion: Lateral plating was much better in as a procedure and outcome wise.

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Clinical Characteristics and Economic Analysis of Intramedullary Nailing Versus Plate and Screws for Open Distal Tibial Fractures: a Retrospective Study

10.21203/rs.3.rs-36128/v1 ◽

2020 ◽

Author(s):

Yibo Xu ◽

Cheng Ren ◽

Zhong Li ◽

Kun Zhang ◽

Teng Ma ◽

...

Keyword(s):

Intramedullary Nailing ◽

Locking Compression Plate ◽

Tibial Fractures ◽

Cost Effectiveness Ratio ◽

Intraoperative Bleeding ◽

Distal Tibial Fractures ◽

Total Cost ◽

Final Treatment ◽

Compression Plate ◽

Surgical Duration

Abstract Background To analyze the clinical characteristic and economic of intramedullary nailing versus locking compression plate for the treatment of open distal tibial fractures.Methods A retrospective analysis was conducted by enrolling patients with open distal tibial fractures who were admitted in Lower Limb Surgery Ward of Traumatic Orthopedic Department，Xi’an Honghui Hospital from January 2016 to January 2019. The collected clinical materials and data included gender, age, injury mechanism, smoke and alcohol, comorbidity disease, Gustilo classification, days before operation, final treatment option, surgical duration, intraoperative bleeding loss, length of stay, complications, Johner-Wruhs criteria, total cost within 1 year after surgery (including hospitalization expenses and postoperative rehabilitation or follow-up expenses). All the patients were divided into two groups based on the final treatment options: Group IMN(intramedullary nailing) and Group LCP(locking compression plate). Cost data for each case within 1 year after surgery were analyzed for the cost-effectiveness ratio (CER)and incremental cost-effectiveness ratio (ICER) of IMN versus LCP.Results 49 consecutive cases were enrolled including 28 cases of Group IMN and 21 cases of Group LCP with the excellent and good rate of 82.1% (23 cases) and 85.7% (18 cases) respectively based on Johner-Wruhs criteria. The surgical duration (p=0.017) and intraoperative bleeding loss(p=0.046) were significantly lower in Group IMN than in Group LCP. Total cost within 1 year after surgery(p=0.048) was also less in Group IMN（126435.90±39093.98 CNY）than in Group LCP（147834.60±56821.12 CNY）. No statistically significant difference was discovered on the excellent and good rate of Johner-Wruhs criteria between the two groups(p＞0.05). The average cost for every 1% of excellent and good rate was 1540.02 CNY in Group IMN and 1725.02 CNY in Group LCP. Each 1% increasing of excellent and good rate cost 5944.08 CNY more in Group LCP compared with Group IMN.Conclusions Both the IMN and LCP could provide a satisfactory outcome for open distal tibial fractures. However the IMN was a more cost-effective management than LCP when the economic analysis was included.

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