Picture of Wimbledon Clinics

Wimbledon Clinics

Repair of distal tibia fracture: which procedure is best?

Contact us for an appointment

*At Wimbledon Clinics we comply with the provisions of the General Data Protection Regulations (GDPR) and the Data Protection Act (UK). We will never share your data without your permission and we will only use your data how you’ve asked us to. Please let us know if you’d like to join our mailing list to receive updates about our specialist consultants, the latest treatments for orthopaedic and sports injuries and prevention tips for common injuries.

For more information, click here to view our privacy policy

tibia.jpg

A study by Oxford Trauma, a research group at the University of Oxford, has compared two methods for repairing a fracture of the distal tibia, revealing which results in better outcomes.

The researchers found that intramedullary nail fixation provides improved quality of life for patients in the 12 months following a distal tibia fracture and costs less than locking plate fixation.

The shin bone (tibia) is the most commonly broken bone in the leg. Injuries in the lower part of the shin bone (distal tibia) usually require surgery, and the two most common types of operation performed for this fracture are modern locking plate fixation and intramedullary nail fixation.

In a randomised clinical trial that involved 321 adults with displaced tibial fracture, the researchers aimed to establish which procedure provides better outcomes for patients.

Using the Disability Rating Index, patients reported their own outcomes at three, six and 12 months after their fracture. Further information was also collected on the patient’s quality of life, complications suffered and associated costs of the treatment.

The Disability Rating Index of both groups of patients improved in the months after their surgery, although patients were not back to normal even a year later, the researchers said.

Patients who had nail fixation of their tibial fracture showed evidence of improvement at three months but there were no differences between the treatments after six months. There was also no difference in the number of complications suffered by each group, but further surgery was more common in the ‘locking’ plate group and quality of life was higher in the nail fixation group.

Additionally, the economic analysis showed that nail fixation was cheaper than locking plate fixation.

The findings have been published in JAMA, the Journal of the American Medical Association.

https://www.ndorms.ox.ac.uk/news/improved_outcomes_for_patients_with_fracture_of_the_distal_tibia

http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2017.16429